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Pediatrics Exam Revision
The parents of a young child who is hospitalized appear nervous and state that they have had terrible past experiences in the hospital. What is the most appropriate nursing action to help promote comfort to this patient and family? A. Ask the child about previous hospitalization. B. Allow the child to draw a picture of previous hospital experience. C. Tell the family that this hospitalization will be different from previous hospitalization. D. Offer clear information on the patient's hospitalization and allow the family opportunities to ask questions. - Correct answer D. Offer clear information on the patient's hospitalization and allow the family opportunities to ask questions. The nurse observes that a 4-year-old patient on the pediatric unit is anxious and appears scared. Which actions can the nurse take to help relieve the fear of hospitalization? Select all that apply. A. Encourage involvement of family members. B. Remove the child from family during procedures. C. Demonstrate procedures and treatments with toys. D. Explain procedures and treatments to family members. E. Reassure the patient that he or she has nothing to be afraid of. - Correct answer A, C A. Encourage involvement of family members.
C. Demonstrate procedures and treatments with toys A young child admitted to the emergency department starts to cry when separated from her mother. How can the nurse help reduce the anxiety of the child? A. Allow the child an outlet for her feelings. B. Explain to the parents the benefits of separation. C. Leave the child's bedside and give the child some space. D. Wait until the child stops crying before speaking to her. - Correct answer A. Allow the child an outlet for her feelings. Allowing the child an outlet for her feelings is an appropriate strategy to help reduce anxiety from a child who is separated from her parent. Separation anxiety is distress and apprehension caused by being removed from parents, home, or familiar surroundings. A 4-year-old patient is afraid of a blood pressure cuff and the nurse would like to find a way to help decrease the child's fear. Which actions can the nurse take to help comfort to the child? Select all that apply. A. Show the child the blood pressure equipment. B. Permit the child to handle the blood pressure equipment. C. Educate the child on the purpose of blood pressure readings. D. Wait until the child is less stressed to take her blood pressure. E. Allow the child to apply the blood pressure cuff to a family members arm to demonstrate it's not painful. - Correct answer B, E
B. Encourage the child to play with another patient's toys. C. Ask the child what activities she would like to engage in. D. Ask the child to draw you a picture of how they are feeling. - Correct answer C. The parent of a patient diagnosed with cancer denies the illness and states, "My child is not sick." What will be the immediate nursing action? A. Ask the parent to define "illness" in his own words. B. Assess the parent's knowledge pertaining to the child's illness. C. Ask the parent why he refuses to believe the child is sick. D. Assume the parent's response will change after the nurse explains the child's illness. - Correct answer B. Assess the parent's knowledge pertaining to the child's illness. Assessment of the parent's knowledge pertaining to the child's illness is the appropriate action for the nurse to perform. Providing education can be a way to empower parents and patients and assessment of the family's knowledge will provide an opportunity for the nurse to educate the family members on the child's condition The sibling of a pediatric patient would like to see his sister but refuses to go into the patient's room. Which intervention should the nurse consider to decrease the sibling's anxiety? A. Ask the family members to comfort the sibling. B. Communicate to the sibling there is nothing to be anxious about. C. Encourage the sibling to stay out of the room until he is comfortable.
D. Allow the sibling to assist with holding the thermometer while obtaining the patient's temperature. - Correct answer D. Allow the sibling to assist with holding the thermometer while obtaining the patient's temperature. Allowing the sibling to assist with simple procedures will decrease the sibling's anxiety and decrease his fears. This also gives the siblings an opportunity to interact together with the health care team The nurse is providing care for a patient who has been in the hospital for the past three weeks. The nurse has become acquainted with family members and notices a close relationship between the patient and the patient's sibling. Which negative actions, by the patient's sibling, could the nurse possibly witness? Select all that apply. A. Refusing to share a portable video game. B. Leaving the room because of feelings of jealousy. C. Teasing the ill child for looking abnormal in the hospital. D. Crying for not receiving as much attention as the sick child. E. Anger toward the sibling for causing the parents pain and strife. - Correct answer B, D, E B. Leaving the room because of feelings of jealousy. > Feeling jealous can be an expected normal response by a sibling who has a brother or sister receiving a lot of care and attention in the hospital. D. Crying for not receiving as much attention as the sick child.> Having some resentment toward the child who is ill would be an expected normal response by a patient's sibling. The sibling may cry, pout, or misbehave to distract from the attention the patient is receiving. E. Anger toward the sibling for causing the parents pain and strife. > Expressing anger for causing the parents pain and strife could be a response by a patient's sibling. Children do not like to see their parents
A. Assess the child's fears. B. Perform procedures early during the day. C. Avoid procedures until the child is comfortable. D. Allow the parents to participate in the procedure. E. Instruct the patient in performing breathing exercises. - Correct answer D, E D. Allow the parents to participate in the procedure. > Allowing the parents at the bedside is an effective coping strategy for a child during a procedure. The parents can be used to comfort and distract the child while the procedure is being performed. E. Instruct the patient in performing breathing exercises. > Guiding the child through breathing exercises is an effective coping strategy for a child during a procedure. Relaxation techniques such as breathing exercises or guided imagery are effective coping strategies. A patient draws a picture of her parents with anger expressed in their faces. What is the priority nursing action? A. Ask the child what the drawing means. B. Ask the child to draw a picture of his parents happy. C. Ask the child why he drew a picture of his parents angry. D. Ask the parents why the child drew the picture of them angry. - Correct answer A. Ask the child what the drawing means. > Asking the child to interpret the picture is allowing the child to express his feelings openly and this sill form an emotional outlet. A nurse has been working with a patient in the therapeutic-play setting for two weeks and notices an improvement in the child's ability to cope with
painful procedures. Which is the next effective strategy to continuing improving the child's ability to tolerate painful procedures? A. Begin to incorporate more unstructured play. B. Continue with the same type of therapeutic play. C. Begin other effective strategies in a non-play setting. D. Note the child's improvement and try a different type of therapeutic play. E. Encourage family members to comfort the child through the painful procedures. - Correct answer A. Begin to incorporate more unstructured play. Since the child has shown success with therapeutic play (ie, the child is able to better tolerate painful procedures), the most effective strategy now will be to have the child move from structured therapeutic play to a more unstructured type of play. A patient admitted to the pediatric unit is upset because she misses playing with her sister, who's at home. What is the most appropriate action by the nurse? A. Question the patient about what sibling activities she misses most. B. Encourage the sibling to visit and to engage in activities with the patient. C. Inform and reassure the patient he will be out of the hospital soon. D. Meet with family members and create a list of activities to help distract the child from wanting to play with siblings. - Correct answer B. During a procedure in the pediatric outpatient center, the nurse notices the patient's sibling is looking on with both concern and curiosity. Which action by the nurse would be most appropriate? Select all that apply.
A. "I will assist the child with daily hygiene needs." B. "I will allow the child to attend school tomorrow." C. "I will continue to allow the child to play with siblings." D. "I will try to avoid bathing the child until the child feels better." E. "I will not allow my child to attend his gymnastics class tomorrow." - Correct answer D, E The nurse checks the newborn's pulse and records 140 beats/min. Which should be the nurse's next action? Obtain an electrocardiogram Assess the oxygen saturation Notify the health care provider Administer oxygen via nasal cannula - Correct answer Assess the oxygen saturation. Match the appropriate temperature measurement to the most appropriate age. - Correct answer 10 years > Oral 4 years > axillary 3 months > temporal The nurse is caring for an 11-month-old infant who has been diagnosed with human immunodeficiency virus (HIV). When the nurse is obtaining vital signs for the child, which actions are appropriate? Obtain the temperature rectally. Observe for signs of respiratory distress. Measure apical heart rate for 60 seconds. Use a manual cuff to measure blood pressure. Auscultate lung sounds. Observe respiratory rate while the child is at play. - Correct answer Observe for signs of respiratory distress. Measure apical heart rate for 60 seconds. Use a manual cuff to measure blood pressure.
Pain can be categorized as either acute or chronic. Which example(s) describes chronic pain? A child who is receiving chemotherapy for neuroblastoma diagnosed 7 months ago An adolescent admitted to the hospital for an appendectomy A child who is experiencing pain from second-degree burns A child with recurring headaches and migraines A teenager suffering from neck pain related to an accident 10 months ago - Correct answer A child who is receiving chemotherapy for neuroblastoma diagnosed 7 months ago. A child with recurring headaches and migraines. A teenager suffering from neck pain related to an accident 10 months ago. Studies have shown that untreated pain at certain times in a child's life can lead to negative effects on child development. Which of the effects can result from untreated pain in a child? Hypertension Less reaction to pain in the future Decrease in growth and development Weight gain Decreased immune function - Correct answer Hypertension Decrease in growth and development Decreased immune function An 8-year-old who has recently learned that she is moving out of state is seeing her primary care provider once again for abdominal pain. The provider has ruled out any physical causes of the pain. Which factor is the most likely cause of the child's pain? Anxiety Celiac disease Constipation Poor diet - Correct answer Anxiety
Exactly! - Correct answer Intravenous (IV) bolus Children are different from adults when it comes to pain medication dosage and administration. Which factor is different between adults and children? Children metabolize drugs faster than adults. Children need standardized dosages like adults. Children, over the age of 10, are only prescribed oral medications. Children are only prescribed opioids PRN. - Correct answer Children metabolize drugs faster than adults What is the best way to schedule medication for a 2-year-old child with constant pain? PRN or as needed ATC or around the clock PCA or patient controlled analgesia One-time IV bolus - Correct answer ATC or around the clock The nurse is assessing vital signs for children. Which patient finding would be most concerning? A 12-year-old patient breathing 30 breaths/min An 8-year-old child with a temperature of 36.8° C A 3-month-old infant with a pulse of 116 beats/min A 4-year-old patient with blood pressure of 90/52 mmHg - Correct answer A 12 year old patient breathing 30 breaths/min The nurse is caring for a 9-year-old child with asthma. Where should the nurse place the pulse oximeter to monitor the child's oxygen saturation? Ear Finger Big toe Forehead - Correct answer Finger The nurse is caring for a 7-month-old infant with influenza. The nurse notes an axillary temperature of 103.7° F. Which action should the nurse take first?
Place the child in an ice bath for 30 minutes Administer an oral antipyretic as prescribed Confirm accuracy and notify the health care Reassess the infant's temperature using a rectal thermometer - Correct answer Confirm accuracy and notify the health care provider. Which applies to the definition of pain? An unpleasant somatic or visceral sensation Associated with actual, potential, or perceived tissue damage Complex and the same experience for each child Can be acute or chronic Children suffer from pain differently than adults - Correct answer An unpleasant somatic or visceral sensation Associated with actual, potential, or perceived tissue damage Can be acute or chronic A nurse is caring for a 4 year old postoperatively after an open reduction and fixation of his right arm. Which type of pain should the nurse expect the child to have? Chronic pain Acute pain Burn pain Recurrent pain - Correct answer Acute pain Recurrent pain is a unique type of pain. Which factors makes recurrent pain different? Recurrent pain may be categorized as acute or chronic pain Common types are headaches or abdominal pain It can be caused by physical, psychological, or both factors Keeping a diary of possible contributing factors can help with diagnosis Recurrent pain is the same as chronic pain - Correct answer Recurrent pain may be categorized as acute or chronic pain Common types are headaches or abdominal pain
Numeric scale Which of the medications listed are considered coanalgesic medications? Colace Gabapentin Amitriptyline Oxycodone - Correct answer Colace Gabapentin Amitriptyline The World Health Organization (WHO) has certain principles that should be followed for pharmacological pain management. Which statement(s) is part of the WHO principles? Using a two step strategy Dosing only PRN medications Dosing at regular intervals Adapting treatment to the individual child Using the appropriate route of administration Using intravenous medications only - Correct answer Using a two step strategy Dosing at regular intervals Adapting treatment to the individual child Using the appropriate route of administration Complementary and alternative medications (CAM) are gaining popularity among parents of ill children. Which of the interventions listed are considered part of the CAM process? Herbal supplements
Chiropractic treatments Senna Åcupuncture Reiki - Correct answer Herbal supplements Chiropractic treatments Acupuntcure Reiki The nurse is about to conduct an interview with a family and a recently admitted 5-year-old child. The nurse closes the door to the room before starting the interview and the parents ask why. Which is the best response by the nurse for the closed door? "I closed the door before we started the interview so that our conversation is not overheard and remains private." "I closed the door to keep you in the room so that we can complete the interview in a timely manner." "I closed the door so that the child does not run around the unit." "I closed the door to keep other health care providers from coming in during the interview." - Correct answer "I closed the door before we started the interview so that our conversation is not overheard and remains private." The student nurse caring for a 10-year-old child addresses the parents as "mom" and "dad" during the admission interview. Which is the best response by the preceptor to the student nurse? "It is OK to use "mom" and "dad" when addressing the parents as long as you know that they are the parents of the child." "It is important to address the parents by "Mr." and "Mrs." or how they prefer to be addressed rather than "mom" and "dad." "I prefer to use the parents' first names when addressing them." "You did an excellent job conducting your interview with the parents, and I have no critiques for you." - Correct answer "It is important to address the parents by "Mr." and "Mrs." or how they prefer to be addressed rather than "mom" and "dad."
Show empathy toward the parent and the situation Treat the parents with respect Information overload can occur when an individual receives too much information at one time. Which action(s) by parents is a sign(s) of information overload? Asking questions regarding the plan of care for the patient Having long periods of silence Yawning and looking around during the conversation Constant fidgeting or attempting to move away by the parents Reiterating the information being communicated from the provider - Correct answer Having long periods of silence Yawning and looking around during the conversation Constant fidgeting or attempting to move away from the parents A 5-year-old is admitted for a fractured jaw due to an automobile accident. The child tells the nurse that he is scared he will die. Which is the most appropriate response by the nurse caring for the child? "Everything is going to be fine. We'll take good care of you." "Don't worry, I will talk with your parents and everything will be fine." "I was in a car accident once, so I know it can be scary." "I know this is a scary situation and it is normal to be scared. Let's talk about what you are scared of." - Correct answer "I know this is a scary situation and it is normal to be scared. Let's talk about what you are scared of." It is important to include the child in the conversation as much as possible. What action(s) can help the nurse include the child in the conversation? Standing over the child while he or she is lying in bed Being honest with the child regarding the care that will be provided Letting the child express fears and concerns Questioning the child directly and without adjunct objects
Using simple words and short sentences to ensure understanding - Correct answer Being honest with the child regarding the care that will be provided Letting the child express fears and concerns Using simple words and short sentences to ensure understanding Pediatric nurses can use creative communication techniques to help children of all ages communicate their thoughts and feelings. What nonverbal technique(s) can the nurse use to communicate with a pediatric patient? Encourage the child to use storytelling. Encourage the child to keep a journal or diary. Encourage the child to draw a picture about his or her feelings. Encourage the child to play. Encourage the child to talk about his or her dreams. - Correct answer Encourage the child to keep a journal or diary Encourage the child to draw a picture about his or her feelings Encourage the child to play The nurse knows that it is important to use therapeutic communication when speaking with families. Which statement represents the goal of therapeutic communication? The goal of therapeutic communication is to streamline the conversations with patients and families. The goal of therapeutic communication is to establish a relationship with the patient and family that is built on trust and respect. The goal of therapeutic communication is to ensure the family hears what the nurse is saying when communicating with them. The goal of therapeutic communication is to persuade the patient and family to use a particular treatment. - Correct answer The goal of therapeutic communication is to establish a relationship with the patient and family that is built on trust and respect.
