NCLEX - PEDIATRICS Day2

The nurse is caring for a 7-month-old client who has suspected bacterial meningitis. The nurse should first assess the client's

• bilateral hearing
• anterior fontanel
• pulse pressure
• Babinski reflex

The nurse is assessing a 4-year-old boy in a pediatric clinic. Which behaviors by the client would concern the nurse for possible Duchenne muscular dystrophy? Select all that apply.

• Frequently trips and falls at home
• Has painful knees and elbows in the morning
• Places hands on the thighs to push up to stand
• Suddenly rigidly extends the arms and legs
• Walks on tiptoes and has disproportionately large calves

The nurse is assessing a 6-year-old client who is experiencing diarrhea caused by Escherichia coli infection. Which of the following findings would be a priority to follow up?

• petechiae noted on the trunk
• multiple blood-streaked stools
• client has resumed a normal diet
• client is requesting a glass of fruit juice

A parent calls the nurse telehealth triage line with concerns about an allergic reaction to something a child ate. Which symptoms should the nurse instruct the parent to assess for to determine if the child is having an anaphylactic reaction? Select all that apply.

• Dyspnea
• Fever
• Lightheadedness
• Skin rash (hives)
• Wheezing

The nurse is teaching the parents of a 4-month-old who has developed positional plagiocephaly (flat head syndrome). Which statement by the parents indicates a need for further teaching?

• I should alternate head positions when the infant is supine.
• I should place the infant in the prone position during naps.
• I will minimize the amount of time the infant is in a car seat.
• I will place interesting toys opposite the affected side.

The nurse is reviewing discharge teaching with the parent of a pediatric client who has a new tracheostomy. Which of the following statements by the parent would indicate a correct understanding of the teaching?

• I will immediately change the tracheostomy tube if my child has difficulty breathing.
• I will provide deep suctioning frequently to prevent any airway obstruction.
• I will remove the humidifier if my child develops more secretions.
• I will travel with two tracheostomy tubes, one of the same size and one a size smaller.

Which statement by the parent of a 6-year-old with cystic fibrosis requires follow-up regarding pancreatic enzyme usage?

• My child may develop difficulty swallowing and risk choking.
• I should provide a low-calcium diet.
• Stretching and strengthening exercises daily are good.
• I’ll remove scatter rugs from our home.

The nurse is reviewing discharge teaching with the parent of a pediatric client with a new tracheostomy. Which statement indicates correct understanding?

• I’ll change the tube immediately if there’s trouble breathing.
• I’ll suction deeply often to prevent blockage.
• I’ll remove the humidifier if secretions increase.
• I’ll travel with two trach tubes, same and smaller size.

A parent of a 10-year-old scheduled for electroencephalogram says, "I’ll allow hot chocolate before the procedure." What response indicates understanding?

• I can allow my child to drink hot chocolate.
• I will wash my child's hair the night before the procedure.
• My child will feel electric shocks during the procedure.
• My child won't remember the procedure.

The nurse is educating graduate nurses about infant CPR. Which statements are appropriate? Select all that apply.

• Perform 2 minutes of CPR before retrieving a defibrillator
• Compress to half the chest’s depth
• Use heel of one hand on sternum
• Use 15:2 compression-to-breath ratio with single rescuer
• Assess brachial pulse for no more than 10 seconds