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TX PLAN TODDLERS CARE EXAM
A 30-month-old toddler is brought to the emergency department in acute respiratory distress, and a diagnosis of laryngotracheobronchitis (viral croup) is made. What is the most important equipment for the nurse to have available when the child is admitted to the pediatric unit? - ✔✔tracheostomy set A toddler undergoes cardiac catheterization as part of a diagnostic workup for pulmonic stenosis. In which part of the cardiovascular system should the nurse expect an increase in pressure? - ✔✔Right ventricle A toddler with lead poisoning is started on chelation therapy. Succimer (Chemet) is ordered. What information should the nurse give the parents concerning the administration of this medication? - ✔✔The contents of the capsules may be sprinkled on food. A mother in the postpartum unit expresses concern that her 3-year-old daughter will be jealous of her new brother. What should the nurse suggest? - ✔✔Bringing home a new baby doll for the daughter when her baby brother is brought home A 2½-year-old toddler is admitted with a fever of 103º F (39.4° C), stiffness of the neck, and general malaise. The diagnosis is acute bacterial meningitis. What is the priority nursing intervention for this child? - ✔✔Instituting droplet precautions During a nap, a 3-year-old hospitalized child wets the bed. What is the best response by the nurse? - ✔✔Change the child's clothes without discussing the incident
A nurse is observing the growth and development skills of several 2-year-olds in the clinic playroom. The nurse determines that the child requiring further evaluation is the one who: - ✔✔Uses echolalia when speaking A mother asks why her 2-year-old toddler's cleft palate was not repaired at the same time that the cleft lip was repaired. What is the best response by the nurse? - ✔✔"The palate usually is repaired before a child starts to speak. Some surgeons prefer to wait up to 2 years." What behavior does a nurse expect from a toddler subjected to prolonged hospitalization with limited parental visits? - ✔✔Correct Cheerful interactions with staff members The mother of a 2½ - year-old child is concerned about how to handle temper tantrums. The nurse replies that tantrums: - ✔✔Can be reduced with the provision of a less stressful environment A toddler has just had a cast applied for a fractured wrist. The wrist and elbow are immobilized. What information should the nurse include in the home care instructions before discharge? (Select all that apply.) - ✔✔Report swelling of fingers. Elevate casted arm when the child is standing. A nurse is obtaining a health history from the parents of a toddler who has recently been diagnosed with acute lymphocytic leukemia. Which early physiological changes does the nurse expect the parents to report? (Select all that apply.) - ✔✔Pale skin Eating less food Purplish spots on the skin
A toddler is admitted to the pediatric unit with diarrhea and severe dehydration. After several days of treatment the child is evaluated. What clinical findings indicate that the child is rehydrated? (Select all that apply.) - ✔✔Decreased hematocrit Increase in daily weight Decreased blood urea nitrogen level A parent tells the nurse in the emergency department, "My 3-year-old has had a fever for several days and has been vomiting." After prescribed measures to reduce the fever have been instituted, what nursing action is most important? - ✔✔Correct Preventing shivering An 18-month-old child has received all required immunizations. What immunization should the nurse explain to a parent will be one of the vaccines required between 4 and 6 years of age? - ✔✔Inactivated poliovirus A 2-year-old boy born with cryptorchidism is to undergo orchiopexy. What should the nurse tell the parents about the anticipated outcome of this surgery? - ✔✔Damage to the undescended testicle will be prevented. A toddler who was admitted in acute respiratory distress is now resting quietly. The parents tell the nurse that they must leave. What should the nurse suggest that the parents do? - ✔✔Plan to visit the child as frequently as possible A nurse is caring for a toddler in acute respiratory distress precipitated by laryngotracheobronchitis. The child has a temperature of 103° F (39.4° C). What is the priority nursing intervention? - ✔✔Monitoring respiratory status continuously
An 18-month-old toddler who has received the appropriate immunizations on time is visiting the pediatric clinic for the next scheduled immunization. What vaccine should the nurse administer? - ✔✔Fourth diphtheria toxoid, tetanus toxoid and acellular pertussis (DTaP) vaccine A 1-year-old child has a congenital cardiac malformation that causes right-to-left shunting of blood through the heart. What clinical finding should the nurse expect? - ✔✔Increased hematocrit A nurse plans to talk to the parents of a toddler about toilet training. What should the nurse tell the parents is the most important factor in the process of toilet training? - ✔✔Correct Parents' attitude about it During the second week of hospitalization for intravenous antibiotic therapy, a 2-year-old toddler whose family is unable to visit often smiles easily, goes to all the nurses happily, and does not express interest in the parent when the parent does visit. The parent tells the nurse, "I'm so happy he's adjusting, but should I be worried about his reaction to seeing me?" What is the best response by the nurse? - ✔✔Correct The child is repressing feelings for the parent. A nurse is evaluating a toddler and the family dynamics of the child's family, in which abuse is suspected. What behavior is expected? (Select all that apply.) - ✔✔The child cringes when approached. The child has unexplained healed injuries. The child lies still while surveying the environment. A toddler with a history of enlarged lymph nodes, prolonged fever that is unresponsive to antibiotics, erythema of the extremities, and a rash is admitted to the pediatric unit with a
take in preparation for the lumbar puncture? - ✔✔Asking the parents what they were told about the test A nurse is performing health screenings of toddlers in a culturally diverse neighborhood. Which child should the nurse consider at risk for β-thalassemia (Cooley anemia)? - ✔✔ 2 - year-old child of Greek descent with a large abdomen A 1-year-old child is found to have nutritional iron-deficiency anemia. What nursing interventions are most important in the care of an infant with iron-deficiency anemia? (Select all that apply.) - ✔✔Conserving the infant's energy Protecting the infant from infection Teaching the parents about nutrition A major developmental milestone of a toddler is the achievement of autonomy. What should the nurse instruct the parents to do to enhance their toddler's need for autonomy? - ✔✔Teach the child to accept external limits A nurse is providing preoperative teaching to the parents of a toddler who is to undergo myringotomy. The nurse explains that the type of infection most common in children that are prone to otitis media is: - ✔✔bacterial The nurse manager of the infection control service is teaching a class for nurses on the care of young children with viral infection-related diarrhea. What therapy should the nurse manager recommend? - ✔✔Oral rehydration therapy until fluid balance is restored A 30-month-old boy with cystic fibrosis is admitted to the pediatric unit with a severe upper respiratory infection. The toddler is small for his age. What pathological process does the nurse know is the cause of his small stature? - ✔✔An absence of pancreatic enzymes
A nurse is caring for a 2½-year-old child who is expressing pain. What is the most reliable indicator of this child's pain? - ✔✔Changes in behavior When is the best time to prepare a toddler for impending surgery? - ✔✔Correct Shortly before the procedure To evaluate kidney function, the nurse must accurately measure the hourly urine output of a 1½-year-old toddler weighing 22 lb who has been admitted with extensive burns. What is the minimum safe output per hour for a child this age? - ✔✔ 10 - 20 During a routine visit to the child health clinic the parent of a 3-year-old girl reports, "My daughter is still sucking her thumb." What is the nurse's best response? - ✔✔Correct "She'll stop when she's ready." A nurse is caring for a toddler with severe dehydration and its associated acid-base imbalance. What compensatory mechanism within the body is activated to counteract the effects of the child's acid-base imbalance? - ✔✔Increased respiratory rate The health care provider is assessing a 2-year-old child for the presence of celiac disease. For what specific signs and symptoms should the nurse be alert? (Select all that apply.) - ✔✔Steatorrhea Distended abdomen Iron-deficiency anemia
A nurse is teaching a class to parents about keeping medications and household cleaning supplies out of the reach of toddlers. The nurse explains that this is necessary because toddlers:
- ✔✔Have a high level of oral activity A 5-year-old child is brought into the clinic with lethargy, abdominal ascites, and peripheral and periorbital edema. The history indicates ongoing diarrhea and decreased urine output. The child is found to have nephrotic syndrome and started on corticosteroid therapy. The nurse informs the parents that after a week or two of medication therapy, they can expect the child to exhibit: - ✔✔Correct What should the nurse teach a mother that will best help her 2½ - year-old son learn to control his behavior? - ✔✔Set limits and be consistent. Several 3 - year-old girls in the daycare center are having a tea party with their dolls. The center's nurse concludes that this behavior is: - ✔✔Appropriate make-believe play A nurse encourages parents to have their toddler's eyes tested especially for monocular strabismus. What should the nurse explain may occur if the condition is not corrected early? - ✔✔Amblyopia will progress in the weak eye. A 2-year-old boy who has fallen from a tree tells his parents and the nurse, "Bad, bad tree." The nurse concludes that the child is within the cognitive developmental norm of Piaget's: - ✔✔Preconceptual operations The parents of a 3-year-old tell the nurse that their child is afraid to sleep alone because of monsters under the bed. They ask for suggestions. What should the nurse recommend? - ✔✔Leave a small light on at night and state, "Monsters aren't allowed in the house."
A nurse notes that a child is exhibiting signs of cerebral palsy. At what age are these signs usually first noticeable? - ✔✔12months A toddler may not be able to confirm that two glasses of water contain the same amount of liquid if one glass of water is poured into a taller, thinner vessel. What is this behavior characteristic called? - ✔✔Inability to conserve A nurse must administer a medication by means of injection to a 2-year-old whose parent is not present. What is the most therapeutic approach for the nurse to use? - ✔✔Warning the child about the injection just before administering it, saying that it is OK to cry, and then comforting the child A mother indicates to the nurse in the pediatric clinic that she is concerned that her 20-month- old son's bedtime thumb-sucking will cause his teeth to protrude. How should the nurse respond? - ✔✔"There is no reason to be concerned about the teeth protruding unless he keeps sucking his thumb after his permanent teeth have come in." A 3-year-old boy has been observed in the clinic waiting room taking toys from others, tearing pages out of books, and striking his mother. The nurse takes time when interviewing the mother to ask about television habits because: - ✔✔Viewing violent programs is positively correlated with the development of aggression When is a toddler considered ready for toilet training? Select all that apply. - ✔✔-When the child is able to sit, walk, and squat
- When the child is capable of removing his or her own clothing
- When the child is able to recognize the urge to defecate or urinate
