PEDS CH 47

While providing care to a 5-month-old girl whose family has a history of food allergies, the nurse instructs the parents about foods to be avoided in the first year of life. Which response by the parents indicates a need for further teaching?

• "She cannot have any cow's milk."
• "I should continue breastfeeding until at least 6 months."
• "Peanuts in any form should be avoided."
• "Any kind of fruit is acceptable."

A nurse is caring for a 12-year-old girl with a severe peanut allergy. The girl's parents are upset because the school does not permit her to carry her EpiPen with her. It must remain in the school's office per school regulations. Which response by the nurse would be most appropriate?

• "She is allowed by law to carry her EpiPen with her; I will talk to school authorities."
• "Let's file an action plan and keep it in the school office in the event of anaphylaxis."
• "Make sure she wears a medical alert bracelet so that school staff know she has allergies."
• "I will be happy to train school authorities and staff to recognize anaphylaxis."

The nurse is caring for a newborn whose mother is HIV positive. The nurse would expect to administer a 6-week course of which medication?

• Lopinavir
• Ritonavir
• Nevirapine
• Zidovudine

The nurse is caring for a child who is having an anaphylactic reaction with bronchospasm. The nurse would expect to administer what medication for bronchospasm as ordered?

• Epinephrine
• Corticosteroid
• Albuterol
• Diphenhydramine

The nurse is caring for a child undergoing highly active antiretroviral therapy (HAART) for HIV infection. The nurse is preparing to administer the prescribed medication. In addition to the nucleoside analog reverse transcriptase inhibitors (NRTls) and the nonnucleoside analog reverse transcriptase inhibitors (NNRTis), the nurse is cognizant that the child will be taking which additional medication as part of the three-drug regimen?

• Protease inhibitors
• Corticosteroids
• Cytotoxic drugs
• Disease-modifying antirheumatic drugs (DMARDs)

The nurse is providing home care instructions for a 13-year-old girl recently diagnosed with systemic lupus erythematosus. Which response by the girl indicates a need for further teaching?

• "I need to wear sunscreen in the summer to prevent rashes."
• "I need to eat a healthy diet, exercise, and get plenty of sleep."
• "I need an eye examination every year."
• "I need to be careful when it is cold; I should always wear gloves."

The nurse is caring for a child who is taking corticosteroids for systemic lupus erythematosus. The nurse closely monitors the child based on the understanding that corticosteroids exert which major action?

• They increase liver enzymes.
• They can mask signs of infection.
• They cause bone marrow suppression.
• They decrease renal function.

The school nurse is walking through the lunchroom when one of the children says she started to feel strange after trading lunches with a friend. Which assessment would be most important?

• Asking if she has a rash anywhere
• Checking if she has any nausea
• Determining if her throat itches
• Asking if she has abdominal pain

The nurse is caring for a child who has undergone stem cell transplantation for severe combined immune deficiency. What finding would the nurse interpret as indicative of graft-versus-host disease?

• Presence of wheezing
• Splenomegaly
• Maculopapular rash
• Chronic or recurrent diarrhea

The nurse is administering intravenous immune globulin (IVIG). The nurse assesses vital signs and for adverse reactions every 15 minutes for the first hour of administration. After the first hour, the nurse most likely would continue to assess the child at which frequency?

• Every 30 minutes
• Every 45 minutes
• Every 60 minutes
• Every 2 hours