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Peds exam 1
| Question | Answer |
|---|---|
| A 6 y/o child does not talk. What is the best way to communicate? | Let them draw a picture to communicate |
| A preschooler is scheduled for surgery. What should the nurse do to prepare them? | Show them a picture of the procedure room |
| What type of object should be used with a 5 y/o to provide comfort? | Transition objects such as dolls |
| Is it normal for a 9 y/o to say “wait, I’m not ready”? | Yes, this is expected |
| Why should sudden rapid movements be avoided with infants and toddlers? | They can scare the pediatric patient |
| What should the nurse NOT ask when giving medication to a child? | “Can you take your medicine for me?” |
| When administering medication to a child, which statement allows the child to choose without giving a yes/no option? | What color would you like? Red/blue straw?” when giving them medication -> “would you like a cup or spoon?” |
| Why should older children and adolescents sometimes be spoken to alone? | To establish trust, promote privacy, and encourage sharing feelings |
| What words should NOT be used when speaking to children? | Shot, bee sting, deaden, taking your BP, stool, test |
| What words should be used instead of “shot”? | Medicine under the skin or poke |
| What communication behaviors help maintain trust with a child? | Using simple words, a quiet voice, and being honest |
| What type of ambulation toy is appropriate for toddlers? | Push toys |
| How long should a child void after surgery? | Within 4–6 hours |
| When should the nurse contact the HCP if a child has not voided after surgery? | After 8 hours |
| What are the NPO hrs guidelines before surgery for clear liquids? | 2 hours before |
| What are the NPO hrs guidelines before surgery for breast milk? | 4 hours before |
| What are the NPO hrs guidelines before surgery for infant formula? | 6 hours before |
| What might a pediatric patient with magical thinking believe about a hospital room? | That the room is coming alive and might eat them |
| How is tube placement best verified? | X-ray or pH best way is xray (after 1st x-ray placement, you can use residual for further feedings |
| What heart rhythm variation is sometimes normal in children? | Sinus arrhythmia (with respirations, falling asleep, waking up.) |
| What should the nurse do first if a pediatric chart shows an increased blood pressure? | Check the temperature first and do not reassess until the temperature has been taken |
| What does stridor indicate? | Upper airway obstruction or swelling |
| What causes wheezing sounds to be higher pitched in children? | A thin chest wall |
| Where are retractions heard in respiratory distress? | Sub-clavicular area |
| What chest ratio is normal in infants and young children? | 1:1 chest ratio |
| What are signs of pain in infants? | Restlessness, grimacing, inconsolable crying, thrashing limbs |
| What does FLACC stand for? | Face, Legs, Arms, Crying, Consolability |
| What age group is FLACC used for? | 2 months to 7 years and non-verbal children |
| What does the C in FLACC stand for? | Consolability |
| What comfort technique can be used for infants during a poke? | Nonnutritive sucking with a pacifier |
| The nurse should inform the worried mom whose child is to receive a vaccination that we can should EMLA cream apply How long before a poke? | 60 minutes |
| At what age should a child be able to manage PCA? | 5 years old |
| Can Family controlled or nurse controlled PCA for 5 yr old? | yes |
| How should explanations be timed for younger children? | The time between explanation and administration should be short |
| What approach and attitude should be used with a child? | Be confident & positive when approaching the child |
| What device should be used for liquid medications? | Oral syringe |
| Where should liquid medication be placed in an infant’s mouth? | Side of the mouth |
| What should never be mixed with medication? | Bottle of formula |
| What can pills only be mixed with if crushed? | Liquids only |
| What should NEVER be used to mix crushed pills? | Milk or formula |
| Can capsules be crushed? | No |
| Where should vaccines be injected in pediatric patients under 5? | Vastus lateralis |
| When does the anterior fontanel close? | 12–18 months |
| When does the posterior fontanel close? | 6–8 weeks |
| Who is responsible for telling a child they are adopted? | Parents |
| What care does adolescents seeking don’t need consent for? | Reproductive/mental health/substance use |
| What may be required if JW parents refuse blood in a life-threatening situation? | may require court order if life-threatening For children requiring blood transfusions, social work may be contacted -> parents might lose temporary custody for child to receive transfusion |
| By what age should birth weight double? | 6 months |
| By what age should birth weight triple? | 1 year |
| By 1 year, how much % should head circumference increase? | 33% |
| By 1 year, how much % should height increase? | 50% |
| At what age do infants walk while holding on to something (cruises)? | 11 months |
| What age does pincer grasp begin? | starts at 8 months neat pincer at 11 |
| At what age does a child deliberately drop objects? | 11 months |
| At what age can a child put objects in and remove them from a container? | 11 months |
| What cognitive stage is birth to 2 years? | Sensorimotor |
| What is object permanence? | Knowing objects exist when not visible |
| What age shows early object permanence, demonstrated by peek-a-boo? | 6 months |
| When does advanced object permanence. Start to experience separation anxiety? | 8–12 months |
| For Social, When does stranger fear begin? | 6–8 months |
| For social, when does attachment, Separation anxiety begins? | 4-8 months |
| When do infants pronounce vowels? | By 2 months |
| When do infants verbalize consonants? | 5–6 months |
| What foods are inappropriate for infants? | Honey, nuts, 2% milk |
| screen for Hgb and if necessary add Iron supplements at which month? | 12 months |
| What is parallel play? | Playing next to others without interaction |
| Push/pull toys (popping fisher vacuum) for age to improve motor coordination? | 15-month-old |
| At what age can a toddler manage a spoon? | 18 months |
| At what age does a child turn pages in a book 2–3 at a time? | 18 months |
| At what age can a child throw a ball overhand? | 18 months |
| What age can they walk up and down stairs? | 2 |
| What gross motor skill should a 2.5-year-old have? | Jumps in place with both feet & Stands on one foot momentarily |
| What is Erikson’s stage for toddlers? | Autonomy vs Shame and Doubt |
| What traditional objects support Erikson - Autonomy vs Shame and Doubt in toddlers? | Blanket or bear |
| What temperament behaviors are common in toddlers? | Temper tantrums, kicking, screaming, breath-holding |
| At what age can children switch to low-fat milk? | 2 years |
| What safety precautions should be taken for toddlers? | Store sharp items, firearms, monitor for animals and strangers |
| When should car seats remain rear-facing? | Until age 2 or recommended weight |
| What age copies circle and cross? | 3 |
| What fine motor skills should a 5-year-old have? | Tie shoes with help, use scissors and pencil well |
| according to Erikson, the primary psychosocial task of the preschool period is developing a sense of? | Initiative |
| How should time be explained to preschoolers? | Explain time with events: “Mom will come after lunch/dinner” |
| How many words are in a 3–4-year-old sentence? | 3–4 words |
| How many words are in a 4–5-year-old sentence? | 4–5 words |
| How many words are in a 5-year-old’s vocabulary? | Over 2100 |
| What type of snacks are appropriate for preschoolers between meals? | Healthy finger foods |
| What are examples of healthy finger food snacks for preschoolers? | Cheese, milk, and fruits |
| Are imaginary friends normal for preschooler? | Yes |
| What types of play are common in preschoolers? | Imaginative and dramatic play such as dress up clothes, dolls, housekeeping toys, telephones, puppets, cars/trucks |
| What friendships are common in school-age children? | Friendships between same gender peers (Best friends) |
| How much does height increase yearly in school-age children? | 5 cm per year bout 2 inches |
| How much does weight increase yearly in school-age children? | 2–3 kg per year about 4.4-6.6 |
| When should scoliosis screening begin? | School age 6-12 |
| At the start of age group should be taught rules of the road? | School-age children 6–12 years |
| Seatbelts, road rules, swimming safety is important for the start of which age group? | School age 6-12 |
| After menarche, how much do girls continue to grow each year? | 2–2.5 inches per year |
| What is the first sign of puberty in boys? | Testicular enlargement |
| How often should females adolescence be screened for Hgb/Hct? | Annually |
| What age group begins thinking about future goals such as college and careers? | Adolescence 12–20 years |
| What causes 70% of teen deaths? | Injuries |
| What eating disorders are more commonly seen during adolescence? | Anorexia and bulimia |
| What age group should participate in driver education courses and practice w/parent? | Adolescence 12–20 years |
| What are the leading causes of teen injury death? | MVA, homicide, suicide |
| What immunizations are given at 6 months? | Hep B, DTaP, Rotavirus, HIB, IPV, Pneumococcal, Influenza |
| Which vaccine is given yearly starting at 6 months? | Influenza |
| What vaccines are given at 4–6 years? | Varicella, DTaP, IPV, MMR |
| Is it safe to give DTaP and IPV if a sibling is immunocompromised? | Yes |
| Which Erikson stage applies to newborns and infants (birth to 1 year)? | Trust vs. Mistrust |
| Which Erikson stage applies to preschoolers ages 3–5 years? | Initiative vs. Guilt |
| Which Erikson stage applies to school-age children ages 6–12 years? | Industry vs. Inferiority |
| Which Erikson stage applies to adolescents? | Identity vs. Role Confusion |
| What body measurements should be screened at 6 months? | Height, weight, head circumference |
| Are infants nose breathers? | Yes |
| What indicates respiratory emergency in children? | Stridor |
| At what age can an adolescent consent to a pelvic exam without a parent or guardian? | 16 years old |
| Which vaccines must be updated before entering kindergarten? | MMR |
| When should pain medication be given for a tonsillectomy? | Before and after the procedure |
| Why should red-dyed foods be avoided after tonsillectomy? | They can be confused with bleeding |
| Lethargy, drooling, inability to swallow or talk, tripod positioning, retractions, high fever are the signs and symptoms of What?? | acute epiglottitis |
| Why is acute epiglottitis a medical emergency? | The airway can become obstructed |
| What is the treatment for acute epiglottitis? | Almost always intubated; prepare for intubation |
| What treatment is used for bronchiolitis (RSV)? | Steroids for pain management |
| What medication does a child with cystic fibrosis need with every meal? | Pancreatic enzymes |
| What happens if a child with cystic fibrosis does not take pancreatic enzymes? | They will have fatty stools |
| What should be done if fatty stools persist in cystic fibrosis? | Increase enzyme dose and contact the provider |
| What type of inheritance is cystic fibrosis? | Autosomal recessive (both parents must carry) |
| What labs are used to determine if a pediatric patient has an infection? | ABGs, sputum culture, and CBC |
| What is the first intervention if a pediatric patient is having trouble breathing? | Re-positioning |
| What is the FIRST breathing treatment to apply when easing respiratory effort in pediatric patients? | Venturi mask |
| What oxygen delivery methods are best for pediatric patients? | Venturi mask, high-flow nasal cannula, and nasal cannula |
| What medication is used during a wheezing attack? | Albuterol |
| What medication is used for croup and stridor? | Racemic epinephrine |
| What is the purpose of steroids in pediatric respiratory conditions? | To reduce inflammation |
| What respiratory infection requires starting with a strep test? | Pharyngitis and tonsillitis |
| If the strep test is positive, what is the next step? | Start antibiotics without a culture |
| If the strep test is negative, what should be done next? | Obtain a culture for viral testing |
| What post-op sign after tonsillectomy may indicate bleeding? | Frequent swallowing |
| What fluids or foods are recommended after tonsillectomy? | Cool fluids and popsicles |
| What foods should be avoided after tonsillectomy? | Foods with red dye |
| What precautions are required for infectious mononucleosis? | No sharing drinks or utensils and frequent rest periods |
| What activity should be avoided with infectious mononucleosis? | Contact sports |
| What equipment should be kept ready for a child with epiglottitis? | Intubation tray and oxygen |
| What should the nurse avoid doing with a child who has epiglottitis? | Do not assess the throat or ask the child to say “ah” |
| What medication treats acute laryngotracheal bronchitis (croup)? | Racemic epinephrine |
| How often do intermittent asthma symptoms occur? | Less than 2 days per week |
| What medication may be needed for intermittent asthma? | may need albuterol rescue inhaler |
| How often do mild persistent asthma symptoms occur? | More than 2 days per week but not daily |
| What treatment is required for moderate persistent asthma? | will need rescue inhaler & preventative medication; |
| What peak flow zone is seen in moderate persistent asthma? | Yellow zone |
| What is the priority action when a child has asthma symptoms in the hospital? | Assess respiratory status first |
| What does the green zone indicate on a peak flow meter? | 80% or above, no medical attention needed |
| What does the yellow zone indicate on a peak flow meter? | 50–80%, symptoms worsening |
| What does the red zone indicate on a peak flow meter? | 50% or less, medical emergency |
| What should always be done after inhaled medication administration? | Rinse mouth and check for thrush |
| Which medications are beta-adrenergic agonists? | Albuterol and terbutaline |
| What is the action of beta-adrenergic agonists? | Bronchodilation and rapid relief |
| Which medication should be given first in an emergency? | Albuterol |
| What side effect should be monitored with albuterol? | Tachycardia |
| What respiratory infection should always be screened with a strep test? | Nasopharyngitis |
| How is nasopharyngitis treated? | Tylenol and dextromethorphan |
| What treatment is used for bronchiolitis/RSV? | Steroids for pain management |
| What isolation precautions are required for RSV? | Contact and droplet precautions |
| What physical finding is associated with cystic fibrosis? | Salty skin |
| You want to suction for which airway? | Upper |
| At what age does an infant begin to roll over? | Around 5 months |
| Education for asthma medications includes which instruction? | Rinse mouth after using an inhaler |
| Acute laryngotracheobronchitis (croup) is typically caused by what? | A virus |
| Which age group experiences physiologic anorexia? | Toddlers |
| For tonsillitis, which nursing recommendations should be given? (Select all that apply) | Offer cool liquids; warm salt water gargles; acetaminophen for pain; finish all antibiotics |
| Expected nursing interventions for a child admitted with epiglottitis include which actions? (Select all that apply) | Maintain a patent airway; keep the patient calm; administer a cephalosporin |
| The patient with infectious mononucleosis should restrict contact sports due to what risk? | Splenic enlargement |
| Why must children rinse their mouth after using inhaled corticosteroids? | To prevent oral thrush |
| What intervention should be done for a child admitted with epiglottitis? (select all that apply) | Maintain patent airway and keep patient calm and administer cephalosporin |
| What vaccine has decreased the incidence of epiglottitis? | HiB |
| What developmental skill should a 3 year old accomplish? | Ride a tricycle |
| What pain scale is appropriate for a 3 year old child? | FLACC |
| What stage is a 2 year old in? | Autonomy versus Shame and Doubt |
| Barky cough, stridor s/s of? | Acute Laryngotracheal Bronchitis |
| Parallel Play is common in which age groups | TODDLERS 1-3 YEARS |
| What should the nurse do if a child with cystic fibrosis continues to have bulky stools while taking pancreatic enzymes? | Contact the HCP to increase the enzyme dose |
| How should the nurse pull the pinna when assessing the ear of a child less than 3 years old? | Pull pinna gently down & back |
| How should the nurse pull the pinna when assessing the ear of a child over 3 years old? | Pull pinna up & back |
| What developmental age milestone should they have Head control ? | 3 month |
| What age Roll from back to front ? | 6 month |
| What age Sits uncontrolled? | 8 months |
| Which Piaget stage includes Peek-a-boo? | Sensorimotor |
| What cognitive concept develops during Piaget’s Sensorimotor stage? | Object permanence |
| Time out should be the same time as their ?? | age |
| What immunization is given at birth? | Hep B |
| Which vaccine is known as the “college vaccine”? | Meningococcal |
| At what age does an infant typically grab a rattle? | 3–4 months |
Created by:
fsanoe