Which is the most appropriate anticipatory guidance to give parents relative to food allergies in infants?

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EXAM 3 (CHAPTER TEST)

Question	Answer
What factors influence the outcomes of the at-risk newborn? Select all that apply. 5	-Environmental factors -Birth weight -Gestational age -Maternal factors -Type and length of newborn illness
The nurse informs the parents of a small-for-gestational-age newborn that complications can occur, including:	Cognitive difficulties.-SGA newborns often subsequently exhibit learning disabilities. The disabilities are characterized by hyperactivity, short attention span, and poor fine motor coordination. Some hearing loss and speech defects also can occur.
Understanding the transition from intrauterine to extrauterine life, what intervention is of high priority when working with an infant of a diabetic mother?	Check blood glucose frequently- frequent blood glucose checks are especially important in the infant of the diabetic mother to ensure that blood glucose levels are being maintained
Which is the most appropriate nursing diagnosis for a newborn who has meconium aspiration syndrome?	Impaired Gas Exchange (lungs and at the cellular level)-Meconium aspiration syndrome causes respiratory issues.
A 28-weeks'-gestation newborn experienced birth asphyxia at the time of delivery. What is a long-term complication of birth asphyxia?	Intraventricular hemorrhage-Birth asphyxia will cause an insult to the brain, and more often than not will cause a bleed or intraventricular hemorrhage
What is the best explanation as to why the nursing diagnosis Risk for Infection often is a complication for the preterm infant? Select all that apply. 2	-Preterm newborns have immature immune systems. -Preterm babies have thin and permeable skin.
What is the best intervention a nurse can utilize to promote parent-infant attachment with a preterm or high-risk newborn?	Caffeine-The effects of other substances, such as nicotine, marijuana, and caffeine-as well as poor diet-combined with alcohol, often enhance the likelihood of FAS.
The preterm newborn of a mother who used cocaine during pregnancy is experiencing vomiting, diarrhea, weight loss, irritability, tremors, and tachypnea. What is the best explanation for these symptoms?	Maternal substance abuse-The severity of W/D that an infant experiences can be assessed by using a scoring system such as the Finnegan scale. This scale is based on observations and measurement of the responses to neonatal abstinence from substances.
The primary goal for the drug-dependent newborn is to reduce withdrawal symptoms and promote adequate respiration, temperature, and nutrition. What intervention best reflects that goal?	Proper positioning in the right side-lying or semi-Fowler's position to avoid possible aspiration of vomitus or secretions is the best choice
Which intervention should the nurse suggest to the parents of a 12-month-old as the most effective way to reduce the incidence of early-childhood caries?	Advise the parents to provide a pacifier instead of a bottle at bedtime.
A mother is concerned that her 5-month-old infant spits out his rice cereal. She thinks he dislikes it. The nurse's best response to the mother is:	"This is a normal response in some babies when they are first fed from a spoon."
A parent is concerned that his 4-year-old will eat only Cheerios and chicken nuggets. The best anticipatory guidance the nurse can offer is:	Offer chicken nuggets and Cheerios with other foods at mealtimes.
Which is the most appropriate anticipatory guidance to give parents relative to food allergies in infants?	Allow 3-5 days between the introduction of new foods.
Nursing assessment of a 14-year-old reveals a BMI in the 90th percentile and a lifestyle that includes spending 4 hours a day playing video games and eating supper while watching television. The priority nursing diagnosis is:	Imbalanced Nutrition: More Than Body Requirements related to excessive intake and sedentary lifestyle.
The parent of a 2-year-old reports that the child drinks six 8-ounce cups of milk per day and eats very little solid food. Based on this information, the nurse should further assess the child for signs of:	Iron-deficiency anemia.
A new mother has questions about breastfeeding and infant formulas. She asks the nurse what the best kind of milk for her full-term baby i The nurse should recommend:	Breast milk for the first year.
The nurse provides a 2-month-old infant's parents with information related to nutrition during the first 6 months. Which statement by the parents indicates that the teaching session was effective?	"We will introduce rice cereal when he is four months old."-Solid foods should be introduced at 4-6 months of age. The first food should be rice cereal, since it has a lesser chance of allergy and is easily digested.
At a 2-year-old's checkup, measurement of weight indicates that the infant has lost 4 pounds since his last checkup. What should the nurse do first?	Reweigh the child.The nurse first should reweigh the child to make sure the weight is accurate. Two-year-olds frequently move around when being weighed, so the most important initial action is to verify the results. After the results are verified, the wei
Nutritional assessment of a 10-year-old indicates the following findings. Which does the nurse recognize as risk alerts? Select all that apply.	-Has been diagnosed with asthma. -Eats one vegetable a day,generally at suppertime.
INFANTS NEEDING RESUSCITATION	WEAK CRY AT BIRTH, POOR RESPIRATORY,RETRACTIONS AT BIRTH
RESUSCITATION METHODS-4	STIMULATION BY RUBBING THE NEWBORNS BACK(DONE INITIALLY TO ALL INFANTS),USE OF POSTIVE PRESSURE TO INFLATE THE LUNGS,ENDOTRACHIAL INTUBATION
RESUSCITATION MEDS	NALOXONE(NARCAN) MAY BE USED TO REVERSE EFFECTS OF NARCOTICS GIVEN TO MOTHER PRIOR TO BIRTH
INFANTS AT RISK FOR RESUS	NONREASSURING FETAL HEART PATTERN PATTERN,MECONIUM STAINED AMNIOTIC FLUID AND OR ACIDOSIS DETECTED BY FETAL SCALP SAMPLE
The nurse is preparing to conduct a health history on a 3-year-old. The nurse knows that a detailed birth history is important when:	The history of present illness might relate to birth history.
The nurse is preparing to assess a child. The physical examination should begin when the nurse:	The physical examination begins with the nurse's first contact with the child. The nurse observes the child's behavior, general appearance, and skin color.
During an assessment of the neck of a 2-year-old child, the nurse notes firm, non-tender, moveable lymph nodes 1 cm in diameter in the cervical chain. The nurse knows to explain this finding to the parent as:	A normal finding in child this age.
A 3-year-old presents to the Emergency Department with signs of respiratory distress. The child has a high fever, is apprehensive, and is drooling. It is imperative that the nurse avoid:	Inspecting the child's mouth and throat with a tongue blade.
Which statement by the mother indicates understanding of the nurse's teaching related to a newborn?	"I should use a blanket to cover my newborn when he is sleeping."
An 11-year-old female has told the nurse she had her first menses. The nurse examines the child and identifies her breast development to be in stage 3. This child's sexual maturity rating (SMR) is likely what number?	SMR is an average of breast and pubic/genital hair development. In females, menarche generally occurs in SMR 4 or breast stage 3-4.
When assessing an 18-month-old child, which technique should the nurse plan to use?	Examine the child on the parent's lap.
During a health history interview with a parent and young child, the nurse can improve the quality of data obtained by: (Select all that apply.)	-Using open-ended questions in the beginning of the interview. -Talking to the child about her favorite TV character
Assessment of the child reveals a separation of the abdominal muscles. The nurse should inform the parents to expect it to close by:	School age
Which of the following findings noted in a 2-month-old infant require further assessment and intervention? Select all that apply.	-Substernal retractions -Respiratory rate of 70
When assessing the food choices of a 9-year-old boy, the nurse learns that the child eats his lunch from the school cafeteria. Which responses by the child would indicate a need for nutritional teaching? Select all that apply.	I don't get the vegetables they have, but have carrots after school as a snack."
Which information obtained during a nursing assessment of a 10-year-old child who is at home alone after school indicates a need for parent education?	The parent allows the child to make a pizza snack in the oven if he gets hungry.
An 11-year-old boy is brought to the physician's office complaining of a sore leg. The boy's father tells the nurse that the child might have injured the leg during football practice. As the nurse is examining the leg, she asks the child about his footbal	The boy states, "I know my Dad wants me to play, but I knew I would get hurt playing football."
The father of a 12-year-old boy asks the nurse about when his son can sit in the front seat of the car and just use the regular seat belt. The nurse measures the child, and he is one inch shorter than the required 4' 9" to be able to sit without a booster	Continue to use a booster seat until the child meets the minimum height required to use a seat belt.
An overweight 11-year-old girl tells the school nurse she would like to be more active, but her parents do not have time to take her places. What are some suggestions the nurse can make for this child to promote health? Select all that apply. 2	Encourage the parents to investigate the option of ride-sharing for afterschool activities with a classmate's family., Suggest that the family plan an activity night where they ride bikes, take a walk, or go to the park.
The home health nurse assesses the home environment of a 2-year-old who is ventilator-dependent. The nurse's priority is to remove which of the following hazards?	A loose extension cord on the floor that is connected to the ventilator
The school nurse has been notified that an 8-year-old who has had a tracheostomy for two years will be attending one of the three schools to which she is assigned. Which action is most appropriate for the school nurse?	Train teachers and health aides to provide appropriate care for the child.
An individualized health plan (IHP) should be developed for which school-age child?	A 10-year-old who will require a wheelchair for the next two months
The child who has complex health issues or who will need special arrangements to navigate the building should have an	IHP
The child with a speech impediment needs an	IEP--individualized education plan
A child is discharged from the hospital after being diagnosed with cystic fibrosis. The home health nurse visits the family a few days after discharge to see how the family is coping with the new diagnosis. Which assessment finding is most indicative that	The nurse observes the parents correctly performing chest physiotherapy on the chilD
Separation anxiety is one of the major stressors of hospitalization for a toddler. How can the nurse best limit the amount of separation anxiety that the hospitalized toddler will experience? Select all that apply. 2	Encourage the parents to remain in the child's room when care is being provided. Encourage parental involvement in the child's care, and suggest rooming in, if possible.
A 16-year-old female has been admitted to the hospital because of a serious respiratory infection with a diagnosis of possible tuberculosis. She has been placed on respiratory isolation in a private room. Knowing that peers are important, what would the n	Maintaining contact with her friends by telephone
A 4-year-old tells the nurse she is bad and that's why she is in the hospital. What is the nurse's most appropriate response?	You are here so we can help you feel better, not because of anything you might have done."
How can the nurse best reduce fear of hospitalization in preschool-age children?	Use Band-Aids or bandages after invasive procedures to reassure the child that his body will not leak and that body parts will not fall out.
A 4-year-old has been hospitalized for several days, and his parents have decided to return to work during the day and spend the evening and night with the child. They have informed the nurse that they will return around 5:30 or 6:00 p.m. During lunch, th	"Your parents will return around suppertime."
The parent of a hospitalized infant expresses the desire to hold her infant, who has been hospitalized with a bacterial infection. What is the most appropriate action by the nurse?	Show the mother how to hold the infant so that intravenous lines are not jeopardized.
A hospitalized 9-year-old states that he does not understand why he needs to have an operation. Based on this statement, which is the most appropriate nursing diagnosis for this child?	Knowledge Deficit: Need For Surgery related to lack of previous teaching
The nurse is providing care for a hospitalized 10-year-old. Which assessment information collected by the nurse validates that the child is in the appropriate stage of development?	The child states that he wants to help remove the bandage from his abdomen.
One way the nurse can ease anxiety about hospitalization for children would be through the use of:	Therapeutic play.
Therapeutic play	Therapeutic play is a technique that nurses can use to better understand children's fears and thoughts. By playing with toys, children can gain mastery of their environment and have their fears and misconceptions dealt with by the nurse.
The nurse is assessing an 11-year-old patient receiving conscious sedation to set a fractured leg. Which assessment finding indicates that the patient might need respiratory support?	Absent gag reflex, The child who does not have a gag reflex is demonstrating signs of deep sedation
In deep sedation	, protective reflexes are lost, and respiratory support is needed
The nurse is evaluating the effectiveness of patient-controlled analgesia for a 10-year-old client. Which outcome is the best indicator that this delivery of pain medication is effective?	The child reports a pain level of 0 on a 0-10 scale.
The nurse caring for a 13-year-old has identified imagery as a way to help the patient with pain management. Which of the following instructions could the nurse use to help the patient use imagery?	"Think about your favorite place to go in the summer."
Imagery involves a ______in which the individual is encouraged to think about something positive, such as a favorite plac	cognitive process
An infant in the neonatal intensive care unit must undergo numerous painful procedures. Which complementary therapy is most appropriate to decrease pain during the procedures?	Numeric scale
The FLACC scale	is an observation scale used primarily in infants and preverbal children.
THE FACES SCALE	and the poker chip tool are most appropriate with preschool- and young school-age children.
The nurse is providing care for an 8-year-old client with a history of juvenile rheumatoid arthritis (JRA). The child takes non-steroidal anti-inflammatory drugs (NSAIDs) on a regular basis to help control discomfort. The most appropriate nursing diagnosi	Chronic Pain related to JRA.
The nurse assesses a 10-year-old male client with multiple fractures shortly after the child arrives on the unit from the Emergency Department. The nurse attempts to assess the child's pain using a number scale and then the Faces scale. The child responds	Administer the prescribed dose of intravenous morphine., Oral analgesics generally do not provide relief as effectively and promptly as intravenous medication does.
The nurse asks a 6-year-old male client to rate his pain using the Faces pain-rating scale. The child is 12 hours postoperative appendectomy. The child chooses the first face, indicating that he does not have any pain, but the child's mother reports that	Administer a dose of prescribed pain medication to the child.
A 3-year-old child is being discharged from the hospital following treatment for an acute illness. The child is scheduled to return to the clinic in 1 week to have blood drawn by venipuncture to reassess electrolyte values. The child's parents ask if ther	Obtain a prescription for EMLA or Ela-max from the physician and instruct parents how and when to apply the medication.
Which of the following behavioral responses and verbal descriptions of pain are characteristic of preschool-age children? Select all that apply.2	Points to where the hurt is. Strikes out physically when painful procedures performed.
The nurse teaches parents that absolute contraindications for pediatric immunizations include:	Anaphylactic reaction to previous immunization.
Immunizations	Immunizations may be given if the child has a mild illness, with or without fever
A 6-year-old child is to receive regularly scheduled immunizations. The parent states the child is not feeling well, and asks the nurse to defer the immunizations until next week. The nurse's best response is to:	Check the child's temperature.,The child's temperature will help the nurse decide if the child has a mild or severe illness.
A father refuses the measles, mumps, and rubella (MMR) immunizations for his child because he does not want the child to suffer pain or injury, and he believes the MMR vaccine injection might cause autism. The priority nursing diagnosis for this father is	Knowledge Deficit (parent): Potential Side Effects of Vaccines, related to lack of correct information.
A mother refuses to have her child receive any immunizations, based on her religious beliefs. The priority nursing diagnosis when planning health teaching for this family is:	Risk for Infection related to incomplete immunization series.
The nurse is discussing the risks and benefits of vaccines with a family, and must secure signed, informed consent for the children to be immunized. The nurse emphasizes that which of the following reactions to vaccines is very rare?	Encephalopathy
A 10-year-old child has just received his first immunization of influenza vaccine. His lips begin to swell, and he states, "It feels like my throat is closing shut and my chest is tight when I breathe." The nurse recognizes these signs as:	A life-threatening reaction to the influenza vaccine.,This child's reaction describes angioedema, laryngeal edema, and respiratory distress, indicating impending anaphylactic shock.
Nurses should include in their assessments that children are more vulnerable than adults during a bioterrorism attack because they have: (Select all that apply.)4	An immature immune system and immature blood-brain barrier. A faster respiratory rate. Thinner, less-keratinized skin. A smaller blood volume.
he school nurse sees a 14-year-old child who presents with fatigue and a nagging cough of 3 weeks' duration that has become productive with thick mucus and is much worse at night. The school nurse suspects pertussis (whooping cough), because vaccine prote	isolate the child and contact the parents.,Isolation is necessary to prevent the disease from spreading to classmates by aerosolized droplet infection
The nurse concludes that a parent of an otherwise healthy child with varicella (chickenpox) has an accurate understanding of the disease when the parent states:	"I will send my child back to school when all the lesions are dry and crusted over.",Varicella no longer is contagious when all the lesions are dry
The nurse assesses a 4-year-old who was adopted from Russia and has had no immunizations. The child does not appear ill, but has a fine pink maculopapular rash that progressed from the face to the neck, chest, and back, then to the extremities, within 3 d	Rubella (German measles),The child's pattern of rash eruption and lymphadenopathy is characteristic of rubella
scarlet fever	he child with ____ has a fine red sandpaper rash that spares the face and appears on the neck and trunk.
after administration	A mild fever is a common reaction 24-48 hours after administration of the diphtheria, tetanus toxoid, and acellular pertussis (DTaP) vaccine. A rash can occur 7-10 days after the administration of the measles, mumps, and rubella (MMR) vaccine.
A parent asks the nurse why her children get fewer ear infections as they grow older. The nurse's answer would be based on knowledge that, as compared with older children and adults, the infant's eustachian tube is proportionately:	Shorter, wider, and more horizontal.,The eustachian tube is shorter, wider, and more horizontal in infants than in older children or adults, allowing bacteria to enter during yawning or sucking.
A nurse performs vision screening in the community. Which of the following children should the nurse refer for additional evaluation?	An infant who tends to hold his head to the right side more than the left
A nurse develops a plan to prevent and manage visual impairment in her community. For infants and children as old as 10, which of the following strategies would the nurse include? Select all that apply.4	Organization of a support group for parents of visually impaired children and a playgroup for visually impaired children,,Collaboration with the school nurses regarding safety programs in schools,and with the Maternal-Child Division to prevent preterm bir
As the nurse performs auditory screening on an infant, the parents ask about potential causes of hearing loss. The nurse reviews many causes of hearing loss, and tells the parents that the most common cause is:	Genetic recessive inheritance.
A limp 10-year-old boy is carried into the Emergency Department by a parent who states that the child has a severe nosebleed. The first action of the nurse is to:	Assess airway patency.
The nursing diagnosis given greatest priority in the care of a child following a tonsillectomy is:	Ineffective Airway Clearance related to impaired swallowing and bleeding.
The school nurse is asked to assist a child who has lost a tooth in a playground injury. To improve the chance that the tooth can be reimplanted, the nurse should:	Place tooth in cold milk.,Prompt treatment could improve the chance that a tooth avulsion can be reimplanted
A parent calls the clinic to determine whether a 6-month-old infant needs to be seen by a health care provider for cold-like symptoms. Which questions yield answers that provide the nurse with information needed to respond to the parent? Select all (3)	"What makes you think that your baby might need to be seen in the clinic?" "Is the infant coughing?" "What is the infant's temperature?"
The school nurse is assessing a 10-year-old with a very inflamed and closed eye who complains of severe pain of 5 days' duration. The child states that there is probably a bit of glass in the eye from breaking an old Christmas tree ornament. The nurse's p	Instruct the parents to take the child to an ophthalmologist.
the nurse is conducting a health history for a 3-year-old. Which information provided by the parent leads the nurse to suspect hearing loss?	The child does not turn her head when someone enters the room.
A nurse is evaluating a child for a skin injury. Which are important nursing considerations for skin care and how it can promote healing with this child? Select all that apply. 3	Sensation to the healing process , Protection from injury to internal organs, Temperature regulation can be important. The skin helps protect the body, provides temperature regulation, synthesizes vitamin D (not C), and creates sensations. It also help
A clinic nurse is teaching a family about the care of their 3-year-old with eczema. Which action would indicate the family understood the teaching?	Parents dress the child in loose cotton clothing.,Never use bubble bath to bathe a child with eczema. The child should be gently blotted dry after the bath, and a moisturizer placed on him within 3 minutes of getting out of the bath. Loose cotton clothing
A nurse is assessing an infant with yellow-red patches with greasy scaling on the scalp and forehead. With which skin condition would this assessment be consistent?	Seborrheic dermatitis,
Eczema	usually is dry and non-greasy
Contact dermatitis and acne	usually are more papular, rather than patchy.
Which concept should the nurse include when educating an adolescent beginning acne treatment with tretinoin (Retin-A)?	Significant improvement might not be apparent for 6-12 weeks.,An adolescent should wait 30 minutes after washing to apply tretinoin (Retin-A)
A 5-year-old is diagnosed with molluscum contagiosum. Which concepts should be included when educating the family about preventing the spread of the virus? Select all that apply. 2	The child may play under sprinkler outside without transmitting the virus. The child should avoid public swimming pools.
When assessing a 10-year-old, which finding would lead the nurse to suspect tinea capitis?	Scaling of the scalp
Tinea corporis	can occur anywhere on the body except the scalp, groin, hands, or feet
Tinea cruris- jock itch	is in the groin area
tinea pedis- altheletes feet	is on the feet.
A school nurse identifies head lice in an 8-year-old student. Which concept should be included when teaching the family about treating this condition?	If the nit cannot be removed from the hair shaft, the hair shaft should be cut.
Anyone can get lice,	regardless of how often one washes one's hair. No conditioner should be used prior to the treatment of lice. The nits can be hard to remove, but none should be left in the hair. Clothing and bedding should be washed in hot water.
A child is admitted to the pediatric unit with burns caused by boiling hot water on the arms, chest, and hands. Which nursing interventions should be included in the plan of care for this child? Select all that apply. 3	Administer intravenous fluids. If fever is present, start antibiotics immediately. Apply moist soaks or ice.
Which nursing intervention would be appropriate in providing care for a 4-year-old brought to the Emergency Department for treatment of frostbite?	Administer analgesics
Nursing interventions:frostbite	would include removing wet clothing and using mildly warm water (at 100-104ºF) to warm the extremity. Give analgesics to decrease pain of the rewarming process. Raise the extremity to improve venous return.
A nurse is assessing a pressure ulcer in a pediatric client. The ulcer appears as a deep crater into the subcutaneous tissue, but does not extend to the adjacent muscle, bone, or supporting tissue. At what stage would this ulcer be classified?	Stage 3
There are four stages of ulcer formation	Stage 1 is nonblanchable erythema of intact skin that does not resolve within 30 minutes of pressure relief. Stage 2 is a partial-thickness injury, such as a blister involving the epidermis or partly into the dermis. Stage 3 is a full-thickness injury thr
SGA	The SGA newborn does not exhibit symptoms of high blood sugars, increased temperatures, and high white blood cell counts.
INFANT OF A DIABETIC MOTHER	The infant's temperature must be assessed before placing the infant under the warmer.
The need for resuscitation of the newborn at risk can be anticipated if what risk factors are present? Select all that apply.4	Difficult birth Multiple births Sepsis with cardiovascular collapse Known congenital diaphragmatic hernia
NEONATAL RISK FACTORS FOR RESUS:	Neonatal risk factors for resuscitation are as follows: non-reassuring fetal heart rate pattern; difficult birth; fetal scalp/capillary blood sample acidosis; history of meconium in amniotic fluid; apneic episode; inadequate ventilation;
NEONATAL RISK FACTORS FOR RESUS:	male infant; prematurity; SGA; multiple births; structural lung abnormality; congenital heart disease; sepsis with cardiovascular collapse.

Which is the most appropriate anticipatory guidance to give parents relative to food allergies in infants?

EXAM 3 (CHAPTER TEST)

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