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Page 1 List two organs contained in the abdominal cavity. - The abdominal cavity contains the stomach, intestines, spleen and liver a. The purpose of cellular respiration is to produce ADP. (T or F)- a. False- (ATP is produced, not ADP) b. Peripheral proteins are found on the outer surface of a cell membrane. (T or F)-b. True c. Exocytosis is the process that occurs to bring biomacromolecules inside the cell. (T or F) - c. False- (This process is called endocytosis) d. Receptor mediated endocytosis uses a signaling molecule from another cell, binding to the cell membrane to bring about changes within the cell proteins. (T or F) - d. True e. Endocytosis is a passive process. It does not require cellular energy expenditure.(T or F) - e. False- (Endocytosis is an active process and requires cellular energy) In your own words, discuss Tay Sachs disease. What organelle within the cell is impacted? What are the symptoms of the disease and why do they occur? - (1)Lysosomes (2) buildup of toxic lipids inside the cell (biomacromolecules) (3) disability and death, In the genetic disease known as Tay Sachs, one of the normally present digestive enzymes inside lysosomes is lacking. Thus, a toxic lipid in the brain cells cannot be broken down. The resulting buildup of lipids in these cells can cause intellectual disability and death. You are observing two cells under the microscope. They are the same type of eukaryotic cell but one appears much larger. Based on appearance alone, which one would you expect to be carrying out respiration ata more active rate, the larger or smaller cell? Explain why. - The smaller cell. Cells need to remain relatively small because as a cell expands the amount of surface area relative to the volume of the cell decreases. The smaller cell is more active because relative to its volume, its surface area is larger than a bigger cell. With a larger surface area (relative to its volume) this allows the metabolic processes to occur faster. Explain what happens to the soft palate during swallowing. Why? - The upward movement of the soft palate prevents food or liquid from entering the nasal passages during swallowing. Air and food pass in which one of the following areas: Trachea, Nasopharynx, Oropharynx, Alveoli - Oropharynx [Date] | a Label the following five items from the diagram: - Label B- Oral Cavity, Label D- Epiglottis, Label E- Glottis, Label F- Trachea, Label G- Esophagus From widest to narrowest, the branches of the bronchial tree are: - Primary bronchi, secondary bronchi, tertiary bronchi, bronchioles Explain why someone who has hypergastrinemia (excessive secretion of gastrin) might develop gastric/stomach ulcers. - Gastrin stimulates the secretions of pepsinogens and hydrochloric acid. Excess amounts would lead to erosion of the stomach lining. Look carefully at the diagram below. Label the following 5 organs of the digestive system. To receive credit for the intestines you must label the specific region. - 3: Stomach, 4: Gallbladder, 7: Jejunum (not small intestine), 9: Appendix (not large intestine), 10: Rectum (not large intestine) Describe parietal cells and chief cells: name their location, secretions and purposes. - The parietal cells (located in the wall of the stomach body) secrete hydrochloric acid, generating a pH of 1.3-3.5. This very acidic pH kills many of the bacteria ingested along with food. In addition, the low pH stops the activity of salivary amylase. The secretion of hydrochloric acid is essential in the activation of pepsin. Chief cells: secrete pepsinogen. Pepsinogen (a pre- enzyme) is secreted by the chief cells in the stomach. Hydrochloric acid converts the inactive pepsinogen (secreted by the chief cells) into the active enzyme pepsin which begins the breakdown of proteins. Label the following bones of the skeleton from the figure below: - 2: Nasal bone, 4: Zygomatic bone, 6: Inferior nasal concha, 7: Maxilla, 8: Mandible Label the bones in the figure below: - A: Trapezium, B: Scaphoid, C: Lunate, D: Triquetral, E: 5th metacarpal (must include both parts for full credit) A patient has a diagnosis of osteoporosis. (1) In your own words, describe this diagnosis and (2) What type of bone cell would they be lacking? Explain your answer. - (1) Osteoporosis is a bone tissue disease. When bone tissue degenerates faster than is replaced, the bones become weak. Brittle bones cause increased pain and are more likely to fracture. (2) They would have decreased osteoblasts which are responsible for bone repair. The bone repair would be unable to keep up with the ongoing breakdown of bone which is done by the work of osteoblasts. Label the following five muscles: - B: Temporalis, C: Orbicularis oculi, E: Zygomaticus major, G: Buccinator, J: Depressor labii inferioris When extensor digitorum contracts, what action(s) occurs? - F. B&D: B. Wrist extension, D. Extension of digits 2-5 Would you expect a male to have estrogen in their bloodstream? Explain why or why not. - (1)Yes. Both male and female bodies produce "all" the sex hormones. However, the ratios A nurse is assisting a group of parents of adolescents to develop skills that will improve communication. The nurse heads one parent states "my son knows he better do what | say". Which of the parenting styles is he exhibiting? A. Authoritarian B. Permissive C. Authroitative D. Passive-A Anurse is performimg family assessment. Which of the following should the nurse include? (select all that apply) A. medical history B. parents’ education level C. child's physical growth D. Support systems E. Stressors-A,B,D,E What is the expected pulse rate of a newborn? - 80 to 180/min What is the expected pulse of a baby 1 week to 3 months? - 12 to 180/min What is the expected pulse of a child 3 months to 2 years? - 70 to 150/min What is the expected pulse of a child 2 to 10 years? - 60 to 110/min What is the expected pulse of a child 10 years and older? - 50 to 90/min What are the expected respirations fo a newborn to one year? - 30 to 35/min What are the expected respirations of a1 to 2 year old? - 25 to 30/min What are the expected respirations of a 2 to 6 year old? - 21 to 25/min What are the expected respirations of a child 6 to 12 years old? - 19 to 21/min What are the expected respirations of a 12 year old and older? - 16 to 19/min What are the normal vitals of an infant? - HR: 80-180 RR: 30-35 BP: 65-80/40-50 Fontanels - should be flat and soft, posterior closes between 6 and 8 weeks, anterior closes between 12 and 18 months Teeth - 6 to 8 teeth by 1 year of age, 20 baby teeth and 32 permanent teeth How long is the Moro reflex present? - until 4 months of age Page 5 How long is the Tonic neck reflex present? - until 3 to 4 months of age How long does the Babinski reflex last? - usually until a year Expected findings of the olfactory (I) nerve in infants , children, and adolescents - Infants: difficult to test Children and Adolescents: indentifies smell through each nostril individually Expected findings of optic nerve (II)? - Infants: looks at face and tracks with eyes Children and adolescents: has intact visual acuity, peripheral vision, and color vision Expected findings for trigeminal nerve? - infants: has rooting and sucking relfex children and adolescents: is able to clencg teeth together and can detect touch on face with eyes closed Anurse is preparing to assess a preschool-age child. Which of the following is an appripirate action by the nurse to prepare the child? A. Allow the child to role play using miniature equipment B. use medical terminology to describe what will happen C. separate th child from her parents during examination D. keep medical equipment visible to the child- A Anurse is checking the vital signs of a 3-year-old during a well child visit, which of the following findings should the nurse report to the provider? A. temperature 37.2C (99.0F) B. Heart rate of 106/min C. Respirations 30/min D. Blood pressure 88/54 mmHg - C Anurse is assessing a child's ears. Which of the following is an expected finding? A. Light reflex is located at the 2 0 clock position B. Tympanic membrane is red in color C. bone landmarks are not visible D. Cerumen is present bilaterally - D A nurse is assessing a 6-month-old infant. Which of the following reflexes shoud! the infant exhibit? A. Moro B. Plantar grasp C. Stepping [Date] | a Page 7 When does separation anxiety begin to occur? - between 4 and 8 months When is there stranger fear in infants? - 6 to 8 months What toys should be used for an infant? - rattles, blocks, brightly colored toys, mirrors, patty cake Infant Immunizations - Birth: hep B 2 months: hep B, IPV, RV, PCV, dtap, HIB 4 months: all of the 2m, hepB 6 month: all the previous Flu shots: 6m to 1 year Infant Nutrition - breast milk first 6 months, solids 4 to 6 months and first solid is usually iron fortified rice ceral, no juice or water is needed for first year, foods introduced one at a time over 4-7 day period to monitor for allergies What are infant safety concers? - choking/aspiration (grapes, coins, candy) burns (sunscnreen, handles turned away from stove, electrical outlets are covered), drowning, rear facing care seat until 2 years, crib slats are no more than 6cm, no pillows, and sleep on back Anurse is assessing a 12 months old infant during a well-child visit. Which of the following findings should the nurse report to the provider? A. closed anterior fontanel B. eruption of 6 teeth C. Birth weight doubled D. Birth length increased by 50 % -C Anurse is performing a developmental screening of a 10-month old infant. Which of the following fine motor skills should the nurse expect to find? (select all that apply) A. grasp a raddle by the handle B. try building a two-block tower C. use a crude pincer grasp D. Place objects into a container E. Walkes with one hand held - A, C Anurse is conducting a well-baby visit with a 4 motnh old infant. Which of the following immunizations should the nurse plan to administer? (select all that apply) A. MMR [Date] a B. IPV Cc. PCV D. varicella E. RV-B,C,E Anurse is providing education about introducing new foods to the parents of a 4 months old infant. The nurse should recommend that the parents introduce which of the following foods first? A. Strained yellow vegetables B. Iron fortified cereals C. Pureed foods D. Whole Milk - B Anurse is providing teaching about dental care and teething to the parent of a 9-monthold. Which of the following statements by the parent indicates an understanding of the teaching? A. | can give my baby a warm teething ring to relieve discomfort B. | should clean my baby's teeth which a cool, wet washcloth C. I can give Advil for up to 5 days while my baby is teething D. I should place diluted juice in the bottle my baby drinks while falling asleep - B Weight gain of todder - 4x their birth weight by 30 months Height gain of toddler - 3 inches per year (7.5cm) Head and chest growth of toddler - head and chest circumference are abotu equal, compared to when they are born, and their head is wider than their chest gross and fine motor skills of a 15-month toddler - expect walking without help, should be able to build a 2 block tower gross and fine motor skills of 18-month toddler - can throw a ball over head gross and fine motor skills of 2 year old toddler - can walk up and down stairs by placing feet on each step and build a 6-7 block tower gross and fine motor skills of 2.5 year old toddler - can jump with both feet and draw circles Language of a toddler - 1 year = 1 word senteces/hollow phrases 2 year = 2-3 word senteces Erikson's stage of Toddlers - autonomy vs shame and doubt, independence, begin to express selves by saying no a lot, thrive on rituals, maintian routines Toddler appropirate activities - blocks, push pull, thick crayons, puzzle E. Annual screenings for phenylketonuria are important - A, C, D Growth of preeschoolers - 4.5-6.5 pounds per year 2.3-3.5 inches per year or 6-9cm Gross motor skills of 3 year old preeschooler - can ride tricycle and jump off bottom step on stairs Gross motor skills of 4 year old preschooler - can skip and hop on one foot and throw the ball over head Gross motor skills of 5 year old preschooler - can jump rope Cognitive development of the preschooler? - Piaget, preoperational phase 4-7 years, moving from preconceptual phase to the phase of intuitive thought, magical thinking, animisim, centration, time Erikson, initiative vs guilt Regression - in preschoolers, another baby in the family can cause the preschooler to regress to bed wetting or thumb sucking, to be expected What are appropirate activities for a preschooler? - playing ball, puzzles, tricyles, dress up, role playing Immunizations of preschooler - 4-6 years, dtap, mmr, IPV and annual flu What does the sleep schedule of a preschooler look like? - 12 hours of sleep, bedtime routine Teeth of preschooler - eruption of primary teeth is finalized by the beginning of the preshool years What may be a safety initiative for preschooler? - protective gear with tricycles Anurse is providing teaching to the parent of a preschool age shcil about methods to promote sleep. Which of the following statements by the parent indicated an understanding of the teaching? A. | wil sleep in the bed with my child if she wakes up during the night B. | will let my child stay up and additional 2 hours on weekend nights C. | will et my child watch television for 30 minutes nust before bedtime each night D. | will keep a dim lamp on in my child's room during the night - D Anurse is conducting a well child visit with a 5 year old child. Which immunizations shoudl the nurse plan to administer to the child? (Select all that apply) Page 11 A. DTaP B. IPV C. MMR D. PCV E. Hib-A, B,C Anurse is preparing an education program for a group of parents of preschool-age children about promoting optimum nutrition. Which of the following information should the nurse include in the teaching? A. saturated fats should equal 20% of total daily caloric intake B. Average calorie intake should be 1800 calories per day C. dailyintake of fruits and vegetables should total 2 servings D. Healthy diets include a total of 8g of protein each day -B A nurse is performing a developmental screening on a3 year old child. WHich of the following skills should the nurse expect the child to perform? A. ride a tricycle B. Hop on one foot C. jump rope D. throw a ball overhead -A Anurse is caring for a preschool age child who says she needs to leave the hospital because her doll is scared to be at home alone. Which of the following characteristics of preoperational thought is the child exhibiting? A. Egocentrism B. Centration C. Animism D. Magical thinking - C Growth of school age children - 4-6 pound weight gain per year and grown 2 inches (6cm) per year, permanent teeth start to come in Piaget cognitive development of school age children - concrete operations, perceptual to conceptual thinking, learsn to tell time, see other perspectives, solve problems Erikson's stage of school age children - industry vs inferiority, trying to make meaning contributions to society and cooperative and compete with others, peer groups important, competitive and cooperative play What types of activites are appropriate for school age children? - board games, hop scotch, bikes, jump rope, organized sports [Date] a Page 13 Immunizations for adolescents - flu, 16-18 years, meningitis before college Injury prevention for adolescents - helmet use, seat belts, driving, susbtance abuse Safe medication administration for children - oral is preferred, smallest measuring device possible, dont mix oral meds in formula, put in side of mouth, hold cheeks, and stroke chin to swallow Administration of ear drops - pinna down and back IM injections - preffered route is vastus lateralis, then the ventral gluteal or in the deltoid, 22- 25 guage with half inch to 1 inch needle IV safe administration - procedure room, away from bed, EMLA cream to numb area is recommneded, avoid terms like bee stink or stick, keep stuff out of sit, parents can stay, swaddle the infant, non-nutritive sucking is offered before, during, and after to infants Anurse is providing teaching about expected changes during puberty to a gorup of parents of early adolescent girls. Which of the following statements by one of the parents indicates and understanding of the teaching? A. girls usually stop growning abotu 2 years after menarche B. girsl are expected to gain about 65 pounds during puberty C. girls experience menstartion prior to breast development D. Girls typiucaly grow more than 10 inches during puberty - A A nurse is providing anticipatory guidance to the parent of a 13 year od! adolescent. Which of the following screenings shoudl the nurse reccomend for the adolescent? (select all that apply) A. body mass index B. blood lead level C. 24 hour dietary recall D. Weight E. Scoliosis - A, D,E A nurse is caring for an adolescent whose mother expresses ocncersn about her child sleeping such long hours. Which of the following conditions shoud! the nurse inform the mother as requiring additional sleep during adolescnets? A. sleep terrors B. rapid growth C. elevated zinc levels [Date] a D. slowed metabolism - B Anurse is teaching class about puberty in boys. Which of the following should the nurse include as the first manifestation of sexual maturation? A. pubic hair growth B. voval changes C. testicular enlargement D. facial hair growth - C Anurse is planning to administer the influenza vaccine to a toddler. Which of the following actions should the nurse take? A. administer subg to the abdomen B. use a 20guage needle C. Divide the medicaiton into two injections D. place the child in supine position - D Anurse is preparing to administer an IM injection to a child. Which of the following muscle gorups is contraindicated? A. Deltoid B. ventrogluteal C. vastus lateralus D. dorsogluteal - D A nurse is teaching a parent of an infant about administration of oral medications. Which of the following should the nurse include in the teaching? (select all that apply) A. use a universal dropper for medication administration B. as the pharamacy to add flavoringto the medication C. add the medication to a formula bottle before feeding D. use the nipple of a bottle to administer the medication E. hold the infant in a semireclining position - B, D, E Anurse is preparing to administer medication to a toddler. Which of the following actions should the nurse take? (select all that apply) A. identiy the toddler by asking the parent B. tell the parent to administer the medication C. calculate the safe dosage D. ask the toddler what toy he wants to hold during administration E. offer juice after the medication-C,D,E A nurse is caring for an infant who needs otic medicatioin. Which of the following is an appropirate action for the nurse to take? A. Hold the infant in an upright position B. pull the pinna downward and straight back C. hyperextend the infants neck D. ensyure that the medication is cool - B Pediatric pain management - self report is only used for children 4 and older, FLACC scale is 2m to 7 years, pain rate ona scale of 0-10 assessing behaviors of the child B. ask the paretns to leave during the procedure C. perform the procedure with the child in his bed D. allow the child to make on choice regarding the procedure E. apply lidocaine and prilocaine cream to three potential insetion sites - A, D, E Hospitalization, illness, and play for the infant - stranger anxiety 6 to 18 months Hospitalization, illness, and play for the toddler - behavior may regress, separtion anxiety, intense reaction to procedure, parallel play Hospitalization, illness, and play for the preschooler - magical thinking, they may think they caused an illness to happen, still experience separtion anxiety, explain the procedure in very simple clear language, give them a choise if possible (cup or spoon), associate play, paly together without much coordination Hospitalization, illness, and play for the school age child - describe pain and increased ability to understand cause and affect, give factual info, tell the truth, encouage contact with peer groups, and express feelings, cooperative play, play in groups, more organized Hospitalization, illness, and play in the adolescent - body image disturbance, feels isolated from peers, give factural info, tell the truth, encoruage contact with peer group, and express feelings, friends can come visit Anurse is caring for a preschooler. Which of the following is the expected behavior of a preschool-age child? A. Describing manifestations of illness B. relating fears to magical thinking C. understanding cause of illness D. awareness of body functioning - B Anurse on a pediatric unit is caring for a toddler. Which of the following behaviors is an effect of hospitalization? (select all that apply) A. believes the experience is a punishment B. experiences separtion anxiety C. displays intense emotions D. axhibits regressive behaviors E. Manifests disturbance in body image - B, C, D Anurse is teaching a parent about parallel play in children. Which of the following should the nurse include in the teaching? A. children sit and observe others playing B. Children exhibit organized play when in a group C. the child plays alone D. The child plays independently when in a group - D Anurse is teaching a group of parents about separation anxiety. Which of the following information shoud! the nurse include in the teaching? A. itis often observed int the school age child Page 17 B. detachment is the stage exhibited in the hospital C. it results in prolonged issues of adaptibility D. kicking a stranger is an example - D anticipatory grief - when death is expected or a possible outcome complicated grief - extends for more than 1 year following the loss parenteral grief - intense, long lasting, and complex sibling grief - differs from adult/parenteral; depend on age and developmental stage Infant/toddler view of death/dying - no concpet of death Preschoolers(3-6) view of death/dying - magical thinking, may feel guilt or shame, views dying as temporary School age (6 to 12) view of death/dying - adult concept of death, express fear through uncooperative behavior Adolescent (12-20) view of death and dying - adult concept of death, resul of peers vs parents, stressed out by changes in physical appearance Physical manifestations of death - senstaion of heat when body feels cool, decreased sentation, loss of sesnes, decrease LOC, swallowing issues, bradycardia, hypotension, Cheyne stokes respirations Nursing responsibilty after death - allow family to stay with body, rock infant/todderl, assist in post-mortem care Anurse is caring for child who is dying. Which of the following are findings of impending death? (select all that apply) A. heightened sense of hearing B. tachycardia C. difficulty swallowing D. sensation of being cold E. cheyne-stokes respirations - C, E Anurse is teaching a parent about complicated grief. Which of the following statements should the nurse make? A. itis considred complicated gried if you are still grieving after 6 months B. personal acitciites are affected wehn expericining complicated grief [Date] a Page 19 Viral: clear, slightly elevated WBC, noraml or slightly elevated protein, normal glucose, negative gram stain Nursing managment for meningitis - it it is suspected put them into droplet precautions, decrease LOC = NPO, provide quite environment, dim the lights, siezure preautions, bacterial will need IV abx, maintian contact precautions for bacerial for 24 hours after abx treatment has started, monitori for increased ICP** infants: bulging fintanels, increase in head circumference, high pitch cyr, bradycarida, adn respiraty changes childre: irritability, headahce, n/v, siexures, braduycardia, adn respiratoruy changes Reyes syndrome - liver dysfunction and cerebral edema, associated with giving hcildren aspirin for a fever, follows a viral illness like the flu, gasterentritis, or varicella, lab tests include: liver enzymes (AST/ALT increase), increased ammonia levels, liver biopsy for diagnosis, CSF analysis s/s: lethargy, irritiabilty, confusion, deliriu, vomtimg, LOC Anurse is caring for a client who has suspected meningitis and a decreased level of consiousness. Which fo the following actions by the nurse is appropriate? A. place the patient on NPO status B. prepare the client for a liver biopsy C. position the patient in dorsal recumbent D. put the client in a protective environment -A Anurse is reviewing cerebrospinal fluid analysis for a client who has suspected meningitis. Which of the following findings shoudl the nurse identify as indicating viral mengingits? (select all that apply) A. negative gram stain) B. normal glucose content C. Cloudy color D. decreased WBC count E. normal protein count - A, B, E Anurse is caring fro a 4 month old infant who has meningitis, Which fo the following findings is associated with this diagnosis? A. fepressed anterior fontanel B. constipation C. presence of rooting reflex D. high pitched crying - D Anurse is caring for a patient who possibly has Reye syndrome. Which of the following is a tisk factor for developing reye syndrome? oy | A. recent hisotyr of infectious cystitis cauased by candida B. recent hisotrial of bacterial otitis media C. recent epidose of gastrenteritis D. Recent episode of Haemophilus influenzae meningitis - C Anurse is developing an inservice about viral and bacterial meningiting. The nurse shoudl include that the introduction of which of the following immunizations decreased the incidence of bacterial meningitis in children? (select all that apply) A. IPV B. PCV C. Dtap D. Hib ETIB-B,D Risk factors for siezures - cerebral edema, fever, trauma, bleeding, toxins in body (lead), hypoglycemia, electrolyte imbalance, infection What are the three phases of tonic-clonic siezures - tonic- arms and legs flex up and head and neck extend; stiff, LOC clonic- jerking movements postical- awake and confused absense seizure - school age childre (4-12), loss of consiousness 5-10 seconds, daydreaming look, drop whats in hands, lip smacking or twitching of face myoclonic - no postical seizure diagnosis - EEG to find cause, prior to EEG no caffien and wash hair seizure medications - carbamasepine, valporic acid, phenytoin, and diazepam Complications of siezures - status epilepticus which a a seizure lasting longer than 30 minutes, medical emergency Anurse is caring for a child who has absence seizures. Which of the following findings should the nurse expect? (select all that apply) A. loss of consciousness B. appearance of daydreamimg C. dropping held objects D. falling to the floor E having a piercing cry - A, B, C Anurse is caring for a child who just experienced a generalized seizure. Which of teh following is the priority actio for the nurse to take? A. Maintain the child in a side ying position B. loosen the childs restricitve clothing C. reorient the hcild to the environment D. not the time and characteristics of the seizure - A 
