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Nursing Care of Hospitalized Children > Pediatrics

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Total Questions : 6

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Question 1:

A nurse is assessing a 2-year-old child who is hospitalized with bronchiolitis. The nurse observes that the child is restless, irritable, and has nasal flaring and intercostal retractions. The nurse should:

A. Ask the parents to leave the room until the child calms down. B. Place the child in a prone position with the head elevated. C. Administer oxygen via nasal cannula at 2 L/min. D. Offer the child a pacifier or a bottle of juice.

Answer and Explanation

Choice A:

Asking the parents to leave the room until the child calms down is not an appropriate action, as it may increase the child's anxiety and distress, which can worsen respiratory status. The parents should be allowed to stay with the child and provide comfort and reassurance.

Choice B:

Placing the child in a prone position with the head elevated is not an appropriate action, as it may compromise airway patency and ventilation. The child should be placed in a semi-Fowler's position or upright on the lap of a parent or caregiver.

Choice C:

Administering oxygen via nasal cannula at 2 L/min is an appropriate action, as it can improve oxygenation and reduce respiratory distress in a child with bronchiolitis. The oxygen flow rate should be adjusted according to pulse oximetry readings and clinical signs.

Choice D:

Offering the child a pacifier or a bottle of juice is not an appropriate action, as it may increase the risk of aspiration and dehydration in a child with respiratory distress. The child should be given small amounts of clear fluids by mouth or intravenously if oral intake is inadequate.

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Question 2:

A nurse is teaching a group of parents about infection control measures for hospitalized children. One of the parents asks, "What are standard precautions?" The nurse should respond by saying:

A. "They are guidelines that apply to all patients regardless of their diagnosis or infection status." B. "They are practices that prevent exposure to bloodborne pathogens such as HIV or hepatitis B." C. "They are protocols that require wearing gloves, gowns, masks, and eye protection when caring for patients with certain infections." D. "They are procedures that involve placing patients in private rooms or with others who have the same infection."

Answer and Explanation

Choice A:

This is the correct definition of standard precautions, which are the basic level of infection control that should be used for the care of all patients in all healthcare settings.

Choice B:

This is the definition of bloodborne pathogen standard, which is a specific type of standard precaution that applies to occupational exposure to blood or other potentially infectious materials.

Choice C:

This is the definition of transmission-based precautions, which are additional infection control measures that are used for patients who are known or suspected to have infections that are spread by airborne, droplet, or contact routes.

Choice D:

This is the definition of isolation precautions, which are a subset of transmission-based precautions that involve separating patients who have certain infections from others to prevent cross-contamination.

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Question 3:

A nurse is evaluating the safety of a 10-year-old child who is hospitalized with a fractured femur. The nurse notices that the child has a call bell, a phone, and a water pitcher within reach on the bedside table. The nurse should:

A. Praise the child for being independent and responsible. B. Remind the child to use the call bell before getting out of bed. C. Move the items to the other side of the bed to prevent falls. D. Check the child's identification band and allergy status.

Answer and Explanation

Choice A:

Praising the child for being independent and responsible is not an appropriate action, as it may encourage the child to perform activities that are beyond their physical abilities or safety limits. The nurse should assess the child's developmental level and provide appropriate guidance and supervision.

Choice B:

Reminding the child to use the call bell before getting out of bed is an appropriate action, as it can prevent falls and injuries in a child with a fractured femur. The nurse should also instruct the child on how to use assistive devices such as crutches or a walker if indicated.

Choice C:

Moving the items to the other side of the bed to prevent falls is not an appropriate action, as it may make them inaccessible to the child and increase their frustration or dependence. The nurse should ensure that the items are within reach and secure on the bedside table.

Choice D:

Checking the child's identification band and allergy status is not an appropriate action, as it is not related to the safety issue of falls. The nurse should perform this action as part of routine care and medication administration.

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Question 4:

A nurse is preparing to admit a 5-year-old child who has chickenpox. Which type of isolation precaution should the nurse implement for this child?

A. Airborne precautions. B. Droplet precautions. C. Contact precautions. D. Neutropenic precautions.

Answer and Explanation

Choice A:

Airborne precautions are indicated for patients who have infections that are spread by small droplet nuclei that can remain suspended in the air and travel over long distances, such as chickenpox, tuberculosis, or measles.

Choice B:

Droplet precautions are indicated for patients who have infections that are spread by large droplet particles that travel up to 3 feet from the source, such as influenza, pertussis, or meningitis.

Choice C:

Contact precautions are indicated for patients who have infections that are spread by direct or indirect contact with the patient or their environment, such as scabies, impetigo, or Clostridium difficile.

Choice D:

Neutropenic precautions are indicated for patients who have low white blood cell counts and are at high risk of acquiring infections from others, such as those undergoing chemotherapy or bone marrow transplantation.

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Question 5:

A nurse is caring for a 3-month-old infant who is hospitalized with rotavirus gastroenteritis. The nurse should monitor the infant for which of the following complications?

A. Dehydration. B. Hypoglycemia. C. Hyperkalemia. D. Metabolic alkalosis.

Answer and Explanation

Choice A:

Dehydration is a common and serious complication of rotavirus gastroenteritis, which causes vomiting, diarrhea, and loss of fluids and electrolytes. The nurse should monitor the infant's intake and output, weight, vital signs, skin turgor, mucous membranes, fontanelles, and urine specific gravity.

Choice B:

Hypoglycemia is not a typical complication of rotavirus gastroenteritis, unless there is severe malnutrition or insulin overdose. The nurse should monitor the infant's blood glucose levels if indicated by signs such as lethargy, jitteriness, or seizures.

Choice C:

Hyperkalemia is not a typical complication of rotavirus gastroenteritis, unless there is renal failure or excessive potassium intake. The nurse should monitor the infant's serum potassium levels if indicated by signs such as muscle weakness, arrhythmias, or cardiac arrest.

Choice D:

Metabolic alkalosis is not a typical complication of rotavirus gastroenteritis, unless there is excessive vomiting or bicarbonate intake. The nurse should monitor the infant's serum pH and bicarbonate levels if indicated by signs such as confusion, tremors, or tetany.

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Question 6:

A nurse is educating a group of parents about the prevention of communicable diseases in children. Which of the following statements should the nurse include in the teaching? (Select all that apply.)

A. "You should wash your hands and your child's hands frequently and thoroughly." B. "You should avoid sharing personal items such as toothbrushes, cups, or utensils with your child." C. "You should keep your child away from other children who have signs of illness such as fever, cough, or rash." D. "You should immunize your child according to the recommended schedule and catch-up guidelines." E. "You should give your child antibiotics whenever they have a sore throat, earache, or runny nose."

Answer and Explanation

Choice A:

Washing hands and the child's hands frequently and thoroughly is an effective way to prevent the transmission of communicable diseases by removing germs and reducing contamination.

Choice B:

Avoiding sharing personal items such as toothbrushes, cups, or utensils with the child is an effective way to prevent the transmission of communicable diseases by avoiding contact with saliva or other bodily fluids that may contain germs.

Choice C:

Keeping the child away from other children who have signs of illness such as fever, cough, or rash is an effective way to prevent the transmission of communicable diseases by avoiding exposure to infectious agents that may be spread by airborne, droplet, or contact routes.

Choice D:

Immunizing the child according to the recommended schedule and catch-up guidelines is an effective way to prevent the transmission of communicable diseases by stimulating the immune system to produce antibodies that protect against specific diseases.

Choice E:

Giving the child antibiotics whenever they have a sore throat, earache, or runny nose is not an effective way to prevent the transmission of communicable diseases, as antibiotics are only effective against bacterial infections and not viral infections. Moreover, overuse or misuse of antibiotics can lead to antibiotic resistance and adverse effects. Further questions

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