Pediatric Conditions - NCLEX-PN
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The school nurse is approached by a 9-year-old boy who is complaining of severe scalp pruritus. Upon closer examination, the nurse concludes that he has a case of head lice (P_ediculosis capitis_). She knows all of the following to be true except .
The school nurse is approached by a 9-year-old boy who is complaining of severe scalp pruritus. Upon closer examination, the nurse concludes that he has a case of head lice (P_ediculosis capitis_). She knows all of the following to be true except .
Children and adults with exceptional personal hygiene are equally affected by head lice. The same applies to people of all socioeconomic groups, genders, and nationalities. All of the other options are true nursing interventions for head lice.
Children and adults with exceptional personal hygiene are equally affected by head lice. The same applies to people of all socioeconomic groups, genders, and nationalities. All of the other options are true nursing interventions for head lice.
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Which of the following terms describes the congenital abnormality of the forebrain in which an infant is born with a diminished brain size?
Which of the following terms describes the congenital abnormality of the forebrain in which an infant is born with a diminished brain size?
Microcephaly denotes a congenital abnormality of the forebrain in which an infant is born with a diminished brain size. Potential causes include fetal alcohol syndrome, congenital rubella, and trisomy 18.
The other answers are all examples of congenital forebrain birth defects:
- Anencephaly is the complete absence of major portions of the brain, skull, and scalp.
- Agyri is the absence of gyri.
- Polymicrogyri is a condition in which gyri are too many, too small, and very shallow.
Microcephaly denotes a congenital abnormality of the forebrain in which an infant is born with a diminished brain size. Potential causes include fetal alcohol syndrome, congenital rubella, and trisomy 18.
The other answers are all examples of congenital forebrain birth defects:
- Anencephaly is the complete absence of major portions of the brain, skull, and scalp.
- Agyri is the absence of gyri.
- Polymicrogyri is a condition in which gyri are too many, too small, and very shallow.
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Anencephaly and other neural tube defects have been linked to maternal deficiency of what nutrient?
Anencephaly and other neural tube defects have been linked to maternal deficiency of what nutrient?
Anencephaly and other neural tube defects have been linked to maternal deficiency of folate. This is most likely due to folate's role in methylation and nucleic acid synthesis. The other nutrients listed are all important to maternal health but have no known correlation with neural tube defects such as anencephaly.
Anencephaly and other neural tube defects have been linked to maternal deficiency of folate. This is most likely due to folate's role in methylation and nucleic acid synthesis. The other nutrients listed are all important to maternal health but have no known correlation with neural tube defects such as anencephaly.
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Periventricular leukomalacia (PVL) is the most common finding on autopsy of newborns with what condition?
Periventricular leukomalacia (PVL) is the most common finding on autopsy of newborns with what condition?
Periventricular leukomalacia is the most common finding on autopsy of newborns with cerebral palsy. PVL involves the softening of the brain tissue and subsequent death of the white matter. This is caused by lack of blood flow to the periventricular area of the brain, which results in necrosis and gliosis of brain tissue. Neonates born with PVL are likely to have mental impairment, motor disorders, and compromised vision and hearing. PVL is usually diagnosed with ultrasound of the head. None of the other conditions listed typically present with this finding.
Periventricular leukomalacia is the most common finding on autopsy of newborns with cerebral palsy. PVL involves the softening of the brain tissue and subsequent death of the white matter. This is caused by lack of blood flow to the periventricular area of the brain, which results in necrosis and gliosis of brain tissue. Neonates born with PVL are likely to have mental impairment, motor disorders, and compromised vision and hearing. PVL is usually diagnosed with ultrasound of the head. None of the other conditions listed typically present with this finding.
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Which of the following would be considered appropriate in the treatment of a child with Lyme disease?
Which of the following would be considered appropriate in the treatment of a child with Lyme disease?
Lyme disease is caused by the bacteria Borrelia burgdorferi. It is a vector-borne disease that is contracted secondary to the bite of an infected tick. Administration of antibiotics is crucial to recovery. Standard precautions are adequate. Restricting fluids, diet, or activity is not necessary.
Lyme disease is caused by the bacteria Borrelia burgdorferi. It is a vector-borne disease that is contracted secondary to the bite of an infected tick. Administration of antibiotics is crucial to recovery. Standard precautions are adequate. Restricting fluids, diet, or activity is not necessary.
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What specific enzyme deficiency accounts for 95% of all cases of congenital adrenal hyperplasia?
What specific enzyme deficiency accounts for 95% of all cases of congenital adrenal hyperplasia?
In 21-hydroxylase deficiency, cortisol production is reduced, which in turn causes adrenocorticotropic hormone (ACTH) to increase. The precursors for the cortisol are then shunted into androgen production since these are steroids, and are thus derived from cholesterol.
In 21-hydroxylase deficiency, cortisol production is reduced, which in turn causes adrenocorticotropic hormone (ACTH) to increase. The precursors for the cortisol are then shunted into androgen production since these are steroids, and are thus derived from cholesterol.
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The postpartum nurse is caring for a family and their new baby, a two day old infant. The baby is "spitting up" following every formula feeding. The nurse may suggest .
The postpartum nurse is caring for a family and their new baby, a two day old infant. The baby is "spitting up" following every formula feeding. The nurse may suggest .
Typically, the digestive system of a 2-day-old infant can only accommodate 15-30 milliliters of formula comfortably. The infant's stomach will grow considerably over the coming weeks. Frequent spitting up could be due to overfeeding. Before switching formula brands, try decreasing the amount fed at each feeding. Increasing the frequency of feedings may add to this problem. Another possibility, that the infant is feeding too fast, may be corrected by using a "slow-flow" instead of a "soft" or "standard" nipple. "Soft" nipples may be helpful in infants with poor suck or latch. While feeding and directly afterwards, it is advised to keep the infant in a semi-upright position.
Typically, the digestive system of a 2-day-old infant can only accommodate 15-30 milliliters of formula comfortably. The infant's stomach will grow considerably over the coming weeks. Frequent spitting up could be due to overfeeding. Before switching formula brands, try decreasing the amount fed at each feeding. Increasing the frequency of feedings may add to this problem. Another possibility, that the infant is feeding too fast, may be corrected by using a "slow-flow" instead of a "soft" or "standard" nipple. "Soft" nipples may be helpful in infants with poor suck or latch. While feeding and directly afterwards, it is advised to keep the infant in a semi-upright position.
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The community health nurse knows that teaching has been effective when the father of a newborn states .
The community health nurse knows that teaching has been effective when the father of a newborn states .
Newborns should be placed on their back, in their crib, with nothing else when put to sleep. The crib may contain a fitted sheet or a light blanket. Crib pads, pillows, and stuffed animals are not advised because they may interfere with the child's ability to breathe.
Newborns should be placed on their back, in their crib, with nothing else when put to sleep. The crib may contain a fitted sheet or a light blanket. Crib pads, pillows, and stuffed animals are not advised because they may interfere with the child's ability to breathe.
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Hippotherapy has the ability to positively impact children who are cognitively, socially, emotionally, or physically challenged. Which of the following therapies is most closely related to hippotherapy?
Hippotherapy has the ability to positively impact children who are cognitively, socially, emotionally, or physically challenged. Which of the following therapies is most closely related to hippotherapy?
Hippotherapy is therapeutic horseback riding for the handicapped. The motion of the horse can help the child develop flexibility and balance. Working with others and animals can help the child cross social and emotional boundaries. A therapy involving animals (pet therapy) is most similar to hippotherapy.
Hippotherapy is therapeutic horseback riding for the handicapped. The motion of the horse can help the child develop flexibility and balance. Working with others and animals can help the child cross social and emotional boundaries. A therapy involving animals (pet therapy) is most similar to hippotherapy.
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Jennifer is a 14-year-old patient who has been diagnosed with diphtheria and subsequently, myocarditis. The nurse implements all of the following except .
Jennifer is a 14-year-old patient who has been diagnosed with diphtheria and subsequently, myocarditis. The nurse implements all of the following except .
Diphtheria is an illness caused by bacteria (Corynebacterium diphtheriae). It is spread through droplets, requiring droplet precautions. Standard precautions should also be used, as with any patient. Delivery of antitoxin and antibiotics are important to a patient's recovery. Enforcing bedrest is important after a patient has developed myocarditis (inflammation of the heart).
Diphtheria is an illness caused by bacteria (Corynebacterium diphtheriae). It is spread through droplets, requiring droplet precautions. Standard precautions should also be used, as with any patient. Delivery of antitoxin and antibiotics are important to a patient's recovery. Enforcing bedrest is important after a patient has developed myocarditis (inflammation of the heart).
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A community health nurse is giving a presentation on pertussis (whooping cough). He tells his audience that which population is most at risk?
A community health nurse is giving a presentation on pertussis (whooping cough). He tells his audience that which population is most at risk?
Children under 4 years of age hold the greatest risk of contracting Pertussis and developing serious complications, including death. Pertussis vaccines are recommended for all age groups. Children can start a vaccination series as early as 2 months of age. New parents are encouraged to become vaccinated before their baby arrives to prevent transmission before the infant is eligible for immunization.
Children under 4 years of age hold the greatest risk of contracting Pertussis and developing serious complications, including death. Pertussis vaccines are recommended for all age groups. Children can start a vaccination series as early as 2 months of age. New parents are encouraged to become vaccinated before their baby arrives to prevent transmission before the infant is eligible for immunization.
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A room designed to accommodate a child with the measles should include which of the following?
A room designed to accommodate a child with the measles should include which of the following?
Measles is an airborne illness. For that reason, air pressure devices are necessary to prevent the spread of infection. Negative air pressure devices will adequately contain the measles virus because air will flow in to the room as opposed to out. Conversely, positive air pressure devices may be used to create an air flow out of a room in severely immunocompromised patients.
Measles is an airborne illness. For that reason, air pressure devices are necessary to prevent the spread of infection. Negative air pressure devices will adequately contain the measles virus because air will flow in to the room as opposed to out. Conversely, positive air pressure devices may be used to create an air flow out of a room in severely immunocompromised patients.
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A mother one hour post birth expresses concern because her baby's head looks slightly cone shaped. The nurse tells the mother that .
A mother one hour post birth expresses concern because her baby's head looks slightly cone shaped. The nurse tells the mother that .
It is normal for a child's head to be slightly misshapen immediately following birth. The infant's skull is composed of bony plates connected by membranes (fontanelles), allowing for accommodation of the baby's growing brain. Caput succedaneum (swelling of the scalp) can also be found following a long delivery. A misshapen head usually resolves on its own and is normal but does not require any medical intervention.
It is normal for a child's head to be slightly misshapen immediately following birth. The infant's skull is composed of bony plates connected by membranes (fontanelles), allowing for accommodation of the baby's growing brain. Caput succedaneum (swelling of the scalp) can also be found following a long delivery. A misshapen head usually resolves on its own and is normal but does not require any medical intervention.
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A baby is born with a heart rate of 99 beats per minute, irregular breathing, good flexion, frowns when you suction the nose, and with pink color throughout the body and limbs. What is the baby's APGAR score at one minute?
A baby is born with a heart rate of 99 beats per minute, irregular breathing, good flexion, frowns when you suction the nose, and with pink color throughout the body and limbs. What is the baby's APGAR score at one minute?
An APGAR (Appearance Pulse Grimace Activity Respiration) score is a quick assessment designed to indicate the condition of the baby after birth. Referring to the APGAR scoring method, point allocations are as follows:
Heart rate of less than 100: 1
Good flexion: 2
Frown (reflex): 1
Irregular respirations: 1
Pink skin color: 2
We add these to get the final APGAR score of 7.
An APGAR (Appearance Pulse Grimace Activity Respiration) score is a quick assessment designed to indicate the condition of the baby after birth. Referring to the APGAR scoring method, point allocations are as follows:
Heart rate of less than 100: 1
Good flexion: 2
Frown (reflex): 1
Irregular respirations: 1
Pink skin color: 2
We add these to get the final APGAR score of 7.
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A baby is born with a heart rate of 60 beats per minute. The baby is not breathing, has limp limbs, is flaccid and pale. What is the baby's APGAR score at 1 minute?
A baby is born with a heart rate of 60 beats per minute. The baby is not breathing, has limp limbs, is flaccid and pale. What is the baby's APGAR score at 1 minute?
An APGAR (Appearance Pulse Grimace Activity Respiration) score is a quick assessment designed to indicate the condition of the baby after birth. Referring to the APGAR scoring method, point allocations are as follows
Heart rate less than 100: 1
Poor flexion: 0
Absent reflex: 0
Apnea: 0
Pallor: 0
We add these individual scores to get the APGAR score of 1.
An APGAR (Appearance Pulse Grimace Activity Respiration) score is a quick assessment designed to indicate the condition of the baby after birth. Referring to the APGAR scoring method, point allocations are as follows
Heart rate less than 100: 1
Poor flexion: 0
Absent reflex: 0
Apnea: 0
Pallor: 0
We add these individual scores to get the APGAR score of 1.
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A pair of new parents are concerned because their baby has lost 4% of it's birth weight at 3 days of life. The nurse instructs the parents to .
A pair of new parents are concerned because their baby has lost 4% of it's birth weight at 3 days of life. The nurse instructs the parents to .
It is common for infants to lose up to 10% of their weight in the first week of life. Greater than a 10% loss indicates a problem. For an infant within these parameters, there is no need to make a change in feedings. Infants in the first week of life should be fed every 2-3 hours if breast feeding and every 3-4 hours if formula feeding.
It is common for infants to lose up to 10% of their weight in the first week of life. Greater than a 10% loss indicates a problem. For an infant within these parameters, there is no need to make a change in feedings. Infants in the first week of life should be fed every 2-3 hours if breast feeding and every 3-4 hours if formula feeding.
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A pediatric nurse is assessing a 4-day-old infant. He notes irregular breathing of 45 breaths per minute. The nurse should .
A pediatric nurse is assessing a 4-day-old infant. He notes irregular breathing of 45 breaths per minute. The nurse should .
It is normal for infants to breathe irregularly. Often, brief periods of apnea are present. Infants should breathe between 30 and 60 times per minute. For this purpose, noting the finding as a vital sign in the patient's chart is the correct action. No further intervention is necessary in response to a normal assessment.
It is normal for infants to breathe irregularly. Often, brief periods of apnea are present. Infants should breathe between 30 and 60 times per minute. For this purpose, noting the finding as a vital sign in the patient's chart is the correct action. No further intervention is necessary in response to a normal assessment.
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Kerry is a first-time mother caring for her new baby boy. She notices that as she touches his cheek, he turns towards that side and opens his mouth. The nurse tells Kerry that this is a reflex called .
Kerry is a first-time mother caring for her new baby boy. She notices that as she touches his cheek, he turns towards that side and opens his mouth. The nurse tells Kerry that this is a reflex called .
The question describes the rooting reflex. The Moro reflex is shown when an infant is startled and/or feels loss of support as if he/she is falling. He/she will extend the arms above the body in a curved shape. The Babinski reflex occurs in response to stimulation of the sole of the foot. Typically, the large toe will extend or remain extended as the others move. Infants may also exhibit plantar grasp with application of pressure to the foot. In plantar grasp, the toes will flex inward. Infants displaying palmar grasp will close their fingers around an object placed in their hand.
The question describes the rooting reflex. The Moro reflex is shown when an infant is startled and/or feels loss of support as if he/she is falling. He/she will extend the arms above the body in a curved shape. The Babinski reflex occurs in response to stimulation of the sole of the foot. Typically, the large toe will extend or remain extended as the others move. Infants may also exhibit plantar grasp with application of pressure to the foot. In plantar grasp, the toes will flex inward. Infants displaying palmar grasp will close their fingers around an object placed in their hand.
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Which of the following findings are abnormal upon assessment of an infant on the third day of life?
Which of the following findings are abnormal upon assessment of an infant on the third day of life?
Hard or firm stools are abnormal for an infant on their third day of life. Typically, infants will have meconium (dark, sticky) stools for the first several days as a result of amniotic fluid ingestion. Over the next couple days they will transition to a seedy yellow (breastfed infants) or peanut butter consistency (formula-fed infants). Acrocyanosis, blue color on the extremities, is normal in infants. Mottling is also common. Infants have a developing cardiovascular system and many capillaries that exist close to the surface of the skin. Milia are normal white spots that frequent the faces of newborns. It is important not to pick or scratch these white spots to prevent scarring. Infants are also frequently born with fine hair called lanugo covering the body's surfaces. Some babies may be born with more lanugo than others.
Hard or firm stools are abnormal for an infant on their third day of life. Typically, infants will have meconium (dark, sticky) stools for the first several days as a result of amniotic fluid ingestion. Over the next couple days they will transition to a seedy yellow (breastfed infants) or peanut butter consistency (formula-fed infants). Acrocyanosis, blue color on the extremities, is normal in infants. Mottling is also common. Infants have a developing cardiovascular system and many capillaries that exist close to the surface of the skin. Milia are normal white spots that frequent the faces of newborns. It is important not to pick or scratch these white spots to prevent scarring. Infants are also frequently born with fine hair called lanugo covering the body's surfaces. Some babies may be born with more lanugo than others.
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Julie is a new registered nurse who is assessing a child in his third month of life. The assessment is part of a routine appointment at a public health clinic. She knows that the anterior fontanelle of most infants closes between .
Julie is a new registered nurse who is assessing a child in his third month of life. The assessment is part of a routine appointment at a public health clinic. She knows that the anterior fontanelle of most infants closes between .
The anterior fontanelle is commonly referred to as the "soft spot" located atop a child's head. It allows considerable brain growth until it closes, generally between 12-18 months. However, the fontanelle may close on some children as early as 9 months.
The anterior fontanelle is commonly referred to as the "soft spot" located atop a child's head. It allows considerable brain growth until it closes, generally between 12-18 months. However, the fontanelle may close on some children as early as 9 months.
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