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NSG222/ NSG 222 Exam 4: (New 2024/ 2025
Update) Family Nursing Review| Questions
and Verified Answers| 100% Correct| A
Grade– Herzing
QUESTION
Labs to monitor in children under age 2 related to medications that are excreted by kidneys? Answer:
QUESTION
TRUE/FALSE: The nurse crushing a tablet to administer to a child should mix the medication with the child's formula. Answer: False (never mix medications with formula or essential food)
QUESTION
how to determine enteral tube placement Answer:
- abdominal x-ray
- pH of aspirate (greater than 5.5)
- check external markings to verify length
- assess for vomiting, coughing, respiratory distress
QUESTION
pain transmission pathway
Answer:
- transduction (activation of nerve cells by stimuli)
- transmission (stimuli sensation relayed to brain)
- perception (interpretation of stimuli)
- modulation (feeling pain)
QUESTION
factors influencing pain Answer:
- age (younger may express more pain)
- gender
- cognitive level
- temperament
- previous pain experience (increased pain throughout life may result in higher tolerance)
- cultural background (not receiving meds may be seen as better in some cultures)
- situation
QUESTION
pediatric pain assessment tools Answer:
- Wong-Baker FACES (ages 3+) - emoji type faces
- Oucher (ages 3+) - actual faces of children
- Poker chip (ages 3+) - 1 to 4 poker chips
- visual analog (ages 5+)
- numeric scale (ages 8+)
- adolescent pediatric pain tool (ages 8 - 15)
QUESTION
non-verbal signs of pain in pediatric patient Answer:
- Infants (0-1): furrowed brows
- Toddlers (1-3): withdrawn, point to pain
- Preschoolers (3-6): withdrawn, hold body part that is painful
- School-Age (6-12): withdrawn, stiff body
Protective reflexes of the infant Answer:
- righting (correct deviation from midline)
- parachute (arms out to the side like using a parachute when going toward the ground)
QUESTION
Piaget's stages of development Answer:
- sensorimotor (0- 2 years): infants think by interacting with the world through their senses
- preoperational (2-7): use symbols to represent their earlier sensorimotor discover- ies. language, make-believe play
- concrete operational (7-11): reasoning becomes logical, non-abstract, cause and effect
- formal operations (11+): sophisticated, hypothetical and abstract thinking
QUESTION
Erikson's stages of development Answer:
- Trust vs. Mistrust (Birth to 12 - 18 months)
- Autonomy vs. Shame and Doubt (12-18 months to 3 years)
- Initiative vs. Guilt (3 years to 5- 6 years)
- Industry vs. Inferiority (5- 6 years to adolescence)
- Identity vs. Role confusion (Adolescence)
- Intimacy vs. Isolation (Early adulthood)
- Generativity vs. Stagnation (Middle adulthood)
- Ego-Integrity vs. Despair (Late adulthood)
QUESTION
Freud's stages of development Answer:
- oral
- anal
- phallic
- latency
QUESTION
Kohlberg's stages of moral development Answer:
- infant: no moral development
- toddler: no moral development
- preschooler: preconventional (good or bad)
- middle childhood: conventional (tries to be good)
- adolescence: postconventional (standards beyond authority)
QUESTION
infant age range Answer: 0 - 12 months
QUESTION
At what age does an infant start to hold their head up? Answer: 4 months
QUESTION
appropriate toys for 1 - 4 months Answer:
- mobile
- mirror
- rattle
- music
- high-contrast patterns**
Answer:
- breast milk or formula for 12 months (switch to whole milk at 12 months)
- solid foods introduced at 4 - 6 months (1 new food per week)
QUESTION
appropriate toys for 6 - 12 months Answer:
- plastic cups
- buckets
- mirror
- blocks
- stacking toys
- balls
- push-pull toys
QUESTION
12 month old milestones Answer:
- birth weight tripled**
- 6 - 8 teeth
- knows name**
- drink from cup**
- security object**
- can use a spoon (prefers fingers)
QUESTION
9 month old milestones Answer:
- crawls**
- sits unsupported
- pulls to stand
- uses pincer grasp
- likes mirrors
- separation anxiety**
QUESTION
discipline for infants Answer:
- set limits
- positive reinforcement
- do not reward bad behavior
- consistency
- maintain routines
QUESTION
anticipatory guidance for pediatric health supervision Answer:
- oral care
- healthy weight
- healthy activity
- personal hygiene
- safe sun exposure
QUESTION
order of physical exam steps of pediatric patient Answer:
- least invasive to most invasive
- based on patient's needs
- may not be in the typical IPPA order
- if child is not crying, may auscultate first
- save ears, mouth, and throat for last (most intrusive)
QUESTION
role of the school nurse
QUESTION
examples of technology-dependence in children Answer:
- oxygen
- tracheostomy tube
- feeding tube
QUESTION
long-term risks for premature infant Answer:
- cognitive delays (intraventricular hem- orrhage)
- learning disabilities
- visual disturbances (retinopathy)
- chronic lung disease (insufficient surfactant)
QUESTION
guidelines for determining mode of safe transportation of pediatric patient- Answer:
- age
- developmental level
- physical condition (able to walk, too much pain to walk)
- destination
QUESTION
methods of transportation in the hospital Answer:
QUESTION
rights of medication administration for pediatric patient Answer:
- patient
- drug
- route
- dose
- time
- documentation
- approach (honesty about med, do not mix w/ essential or favorite food)
QUESTION
medication absorption in pediatric patients Answer:
- oral: increased pH, increased gastric motility
- IM: decreased due to less muscle mass/tone
- Sub
QUESTION
decreased due to less perfusion
- topical: increased due to larger body surface area, greater permeability of skin
QUESTION
toddler age range Answer: 1 - 3 years
QUESTION
expected developmental growth for toddlers
up to 36 month old milestones Answer:
- plays on riding toys
- takes steps on tiptoes**
- stands on one foot
- dresses/undresses with assistance
- scribbles
- builds tower of >6 blocks**
- shows hand preference
- has most of baby teeth
QUESTION
toddler type of play Answer: parallel: imitate one another, side-by-side play
QUESTION
rules for timeouts Answer:
- start time when child is quiet
- use 1 minute for each year of age
- place toddler in a safe area
- explain reason for time out
QUESTION
preschool age range Answer: 3 - 5 years
QUESTION
preschool growth rate
Answer:
- grow 2.5 - 3 inches per year
- gain 4 - 5 pounds per year
QUESTION
3 year old milestones Answer:
- runs easily**
- undress themselves**
- walks up and down stairs with alternating feet
- builds tower of 9 - 10 blocks**
- screws/unscrews lids**
- turns book pages
QUESTION
4 year old milestones Answer:
- hop and stand on one foot**
- throws ball overhand
- catches bounced ball**
- kicks ball**
- uses scissors
- draws circles and squares**
- laces shoes
- draws person with 2 - 4 body parts
QUESTION
Preschool type of play Answer: associative: play with another child but not organized or coordinated with one another
Answer: cooperative: improved coordination, balance, fine motor
QUESTION
car seat safety Answer:
- toddlers are rear facing until age 2 or more than height/weight restrictions for seat
- booster seat until seat belt crosses the shoulder/chest appropriately (4' 9")
- children under 13 should not ride in the front seat with an airbag
QUESTION
atraumatic care Answer: minimizes or eliminates psychological and physical distress of children and families in healthcare system (do no harm)
QUESTION
basis of atraumatic care Answer:
- minimize parent/child separation
- identify stressors
- prevent/minimize pain
QUESTION
techniques for providing atraumatic care Answer:
- explain procedure in easy-to-un- derstand child terms
- show equipment that will be used
- let child know if the procedure will be painful
QUESTION
child life specialist Answer: trained professional who specializes in the psychosocial care of and communication with pediatric patients and their families based on developmental level
QUESTION
ways to minimize physical stressors Answer:
- therapeutic hugging (being held tightly in parent's lap)**
- distraction
QUESTION
distraction techniques Answer:
- sing / play music
- sibling support**
- blow bubbles
- squeeze caregiver's hand
- look at pictures
- read a book
QUESTION
3 components of health supervision Answer:
- developmental screening & vaccines
- injury & disease prevention
- health promotion
QUESTION
What vaccines are given at 4 months? Answer:
- RV (Rotavirus)
- DTaP
- Hib
- PCV
- IPV
QUESTION
What vaccines are given at 6 months? Answer:
- Hep B
- RV (Rotavirus)
- DTaP
- Hib
- PCV
- IPV
- Influenza
