أسئلة في تمريض الأطفال

1. A female child, age 2, is brought to the emergency department after ingesting an unknown number of aspirin tablets about 30 minutes earlier. On entering the examination room, the child is crying and clinging to the mother. Which data should the nurse obtain first?

Heart rate, respiratory rate, and blood pressure

Recent exposure to communicable diseases

Number of immunizations received

Height and weight

The most important data to obtain on a child’s arrival in the emergency department are vital sign measurements. The nurse should gather the other data later.

Explanation

The most important data to obtain on a child’s arrival in the emergency department are vital sign measurements. The nurse should gather the other data later.

2. While examining a 2-year-old child, the nurse in charge sees that the anterior fontanel is open. The nurse should:

Notify the doctor

Look for other signs of abuse

Recognize this as a normal finding

Ask about a family history of Tay-Sachs disease

Because the anterior fontanel normally closes between ages 12 and 18 months, the nurse should notify the doctor promptly of this finding. An open fontanel does not indicate abuse and is not associated with Tay-Sachs disease.

Explanation

Because the anterior fontanel normally closes between ages 12 and 18 months, the nurse should notify the doctor promptly of this finding. An open fontanel does not indicate abuse and is not associated with Tay-Sachs disease.

3. Nurse Rola is administering a medication via the intraosseous route to a child. Intraosseous drug administration is typically used when a child is:

Under age 3

Over age 3

Critically ill and under age 3

Critically ill and over age 3

In an emergency, intraosseous drug administration is typically used when a child is critically ill and under age 3.

Explanation

In an emergency, intraosseous drug administration is typically used when a child is critically ill and under age 3.

4. When administering an I.M. injection to an infant, the nurse in charge should use which site?

Deltoid

Dorsogluteal

Ventrogluteal

Vastus lateralis

The recommended injection site for an infant is the vastus lateralis or rectus femoris muscles. The deltoid is inappropriate. The dorsogluteal and ventrogluteal sites can be used only in toddlers who have been walking for about 1 year.

Explanation

The recommended injection site for an infant is the vastus lateralis or rectus femoris muscles. The deltoid is inappropriate. The dorsogluteal and ventrogluteal sites can be used only in toddlers who have been walking for about 1 year.

5. When developing a plan of care for a male adolescent, the nurse considers the child's psychosocial needs. During adolescence, psychosocial development focuses on:

Becoming industrious

Establishing an identity

Achieving intimacy

Developing initiative

According to Erikson, the primary psychosocial task during adolescence is to establish a personal identity confusion. The adolescent attempts to establish a group identity by seeking acceptance and approval from peers, and strives to attain a personal identity by becoming more independent from the family. Becoming industrious is the developmental task of the school-age child, achieving intimacy is the task of the young adult, and developing initiative is the task of the preschooler.

Explanation

According to Erikson, the primary psychosocial task during adolescence is to establish a personal identity confusion. The adolescent attempts to establish a group identity by seeking acceptance and approval from peers, and strives to attain a personal identity by becoming more independent from the family. Becoming industrious is the developmental task of the school-age child, achieving intimacy is the task of the young adult, and developing initiative is the task of the preschooler.

6. A mother asks the nurse how to handle her 5-year-old child, who recently started wetting the pants after being completely toilet trained. The child just started attending nursery school 2 days a week. Which principle should guide the nurse's response?

The child forgets previously learned skills

The child experiences growth while regressing, regrouping, and then progressing

The parents may refer less mature behaviors

The child returns to a level of behavior that increases the sense of security.

The stress of starting nursery school may trigger a return to a level of successful behavior from earlier stages of development. A child’s skills remain intact, although increased stress may prevent the child from using these skills. Growth occurs when the child does not regress. Parents rarely desire less mature behaviors.

Explanation

The stress of starting nursery school may trigger a return to a level of successful behavior from earlier stages of development. A child’s skills remain intact, although increased stress may prevent the child from using these skills. Growth occurs when the child does not regress. Parents rarely desire less mature behaviors.

7. A female child, age 6, is brought to the health clinic for a routine checkup. To assess the child's vision, the nurse should ask:

“Do you have any problems seeing different colors?”

“Do you have trouble seeing at night?”

“Do you have problems with glare?”

“How are you doing in school?”

A child’s poor progress in school may indicate a visual disturbance. The other options are more appropriate questions to ask when assessing vision in a geriatric patient.

Explanation

A child’s poor progress in school may indicate a visual disturbance. The other options are more appropriate questions to ask when assessing vision in a geriatric patient.

8. A child with a poor nutritional status and weight loss is at risk for a negative nitrogen balance. To help diagnose this problem, the nurse in charge anticipates that the doctor will order which laboratory test?

Total iron-binding capacity

Hemoglobin

Total protein

Serum transferrin

A negative nitrogen balance may result from inadequate protein intake and is best detected by measuring the total protein level. Measuring total iron-binding capacity, hemoglobin, and serum transferrin levels would help detect iron-deficiency anemia, not a negative nitrogen balance.

Explanation

A negative nitrogen balance may result from inadequate protein intake and is best detected by measuring the total protein level. Measuring total iron-binding capacity, hemoglobin, and serum transferrin levels would help detect iron-deficiency anemia, not a negative nitrogen balance.

9. Salma, with suspected rheumatic fever, is admitted to the pediatric unit. When obtaining the child's history, the nurse considers which information to be most important?

A fever that started 3 days ago

Lack of interest in food

A recent episode of pharyngitis

Vomiting for 2 days

A recent episode of pharyngitis is the most important factor in establishing the diagnosis of rheumatic fever. Although the child may have a history of fever or vomiting or lack interest in food, these findings are not specific to rheumatic fever.

Explanation

A recent episode of pharyngitis is the most important factor in establishing the diagnosis of rheumatic fever. Although the child may have a history of fever or vomiting or lack interest in food, these findings are not specific to rheumatic fever.

10. When assessing a child's cultural background, the nurse in charge should keep in mind that:

Cultural background usually has little bearing on a family’s health practices

Physical characteristics mark the child as part of a particular culture

Heritage dictates a group’s shared values

Behavioral patterns are passed from one generation to the next

A family’s behavioral patterns and values are passed from one generation to the next. Cultural background commonly plays a major role in determining a family’s health practices. Physical characteristics do not indicate a child’s culture. Although heritage plays a role in culture, it does not dictate a group’s shared values and its effect on culture is weaker than that of behavioral patterns.

Explanation

A family’s behavioral patterns and values are passed from one generation to the next. Cultural background commonly plays a major role in determining a family’s health practices. Physical characteristics do not indicate a child’s culture. Although heritage plays a role in culture, it does not dictate a group’s shared values and its effect on culture is weaker than that of behavioral patterns.

11. The nurse is aware that the most common assessment finding in a child with ulcerative colitis is:

Intense abdominal cramps

Profuse diarrhea

Anal fissures

Abdominal distention

Ulcerative colitis causes profuse diarrhea, intense abdominal cramps, anal fissures, and abdominal distentions are more common in Crohn’s disease.

Explanation

Ulcerative colitis causes profuse diarrhea, intense abdominal cramps, anal fissures, and abdominal distentions are more common in Crohn’s disease.

12. Nurse Walid suspects that a child, age 4, is being neglected physically. To best assess the child's nutritional status, the nurse should ask the parents which question?

“Has your child always been so thin?”

“Is your child a picky eater?”

“What did your child eat for breakfast?”

“Do you think your child eats enough?”

The nurse should obtain objective information about the child’s nutritional intake, such as by asking about what the child ate for a specific meal. The other options ask for subjective replies that would be open to interpretation.

Explanation

The nurse should obtain objective information about the child’s nutritional intake, such as by asking about what the child ate for a specific meal. The other options ask for subjective replies that would be open to interpretation.