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Peds Exam 1 Study Guide:- Questions And Answers

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Peds Exam 1 Study Guide:- Questions And Answers

Understand what kind of toys a 12-month-old toddler can have if the toddler
is in contact precautions. Right Ans - Large blocks, toys that pop apart,
push and pull toys (all age-appropriate toys for a 12 month old)

A nurse is caring for a 12-month-old toddler who is hospitalized and confined
to a room with contact precautions in place. Which of the following toys
should the nurse recommend in order to meet the developmental needs of the
client?
A. Large building blocks
B. Hanging crib toys
C. Modeling clay
D. Crayons and a coloring book Right Ans - A. Large building blocks

Understand how an 18-month-old toddler who has been hospitalized for 10
days may act (the behaviors or developmental reactions that are exhibited)
Right Ans - Separation anxiety during hospitalization manifests in three
behavior responses:
-Protest: screaming, clinging to parents, verbal and physical regression
toward strangers
-Despair: Withdrawal from others, depression, decreased communication,
developmental regression
-Detachment: interacting with strangers, forming new relationships, happy
appearance

Impact of hospitalization on toddlers:
-Experiences separation anxiety
-Can exhibit an intense reaction to any type of procedure due to the intrusion
of boundaries
-Behavior can regress

A nurse is caring for an 18 month old toddler who has been hospitalized for
10 days. after the toddler's mother leaves the room, the nurse observes the
toddler sitting quietly in the corner of the crib, sucking her thumb. When the
nurse approaches the crib, the toddler turns away from the nurse. the nurse

,should understand that these behaviors indicate which of the following
developmental reactions?
a. anxiety reaction to the stress of hospitalization
b. regression
c. resentment toward the mother
d. developing autonomy Right Ans - A. An anxiety reaction to the stress of
hospitalization

What does Erikson suggest about a 10 year old who has been hospitalized for
a length of time regarding their assignments/school work? Right Ans -
School-age children (6-12 years):
Provide factual information
Encourage the child to express feelings
Try to maintain a normal routine for long hospitalizations, including time for
school work
Encourage contact with peer groups

A nurse is caring for a 10 year old child who will need to be hospitalized for an
extended period of time. Which of the following actions should the nurse
include in the nursing plan to meet the client's psychosocial needs according
to Erikson?
A. Arrange for the hospital teacher to do lesson plans
B. Allow the client to select his own food off the menu
C. Encourage visits from the client's friends
D. Provide a daily session with a play therapist Right Ans - A. Arrange for
the hospital teacher to do lesson plans
-Encourage the client to complete school work

Industry vs. Inferiority stage of development. By keeping up with school work
through a normal routine, the child will feel less inferior to his classmates due
to the missed school.

Know infant's vital signs. What location is to assess a heart rate? Right Ans
- Apical pulse is most accurate for infant heart rate (apex of the heart; tip of
right and left ventricle on the patient's left side)

Infant (1 month to 12 months) Vital Signs:

TEMP:

,3-6 months: 37.5 degrees C (99.5 F)
12 months: 37.7 degrees C (99.9 F)
Recommended Routes: Axillary; rectal if exact measurement is necessary

HR:
90-160 BPM

RR:
25-30/min

BP:
Average: 85/50
Age, height, and sex all influence BP

A nurse is planning care for an infant. Which if the following would be the
most appropriate site to assess a pulse?
A. Carotid artery
B. Apex of the heart
C. Brachial artery
D. Temporal artery Right Ans - B. Apex of the heart (apical pulse)

-The most effective way to asses an infant's heart rate is by auscultating the
apex of the heart.
-From birth to age 3 years the apex beat is located in the 4th intercostal space;
patient's left side and with increasing age gradually moves into the 5th space
in most children.
-Apical pulse should be assessed by listening between the sternum and the left
nipple

Know about teaching personnel to measure a newborn's respiratory rate.
Right Ans - Count for a complete minute because newborns are irregular
breathers (30-60 BPM normal range)

A nurse is teaching an assistive personnel to measure a newborn's respiratory
rate. Which of the following statements indicates an understanding of why the
respiratory rate should be counted for a complete minute?
a. Newborns are abdominal breathers
b. Newborns do not expand their lungs fully with each respiration
c. Activity will increase the respiratory rate.

, d. The rate and rhythm of breath are irregular in newborns Right Ans - d.
The rate and rhythm of breath are irregular in newborns

Rationale: Newborns have an irregular respiratory rate and rhythm.
Therefore, counting the respiratory rate for a complete minute is
recommended to obtain an accurate rate
-Other options are correct; however, they have no impact on obtaining a
respiratory rate

Know the psychosocial development of a toddler Right Ans - Toddler: 1 -3
years

Erikson Psychosocial development: Autonomy versus shame and doubt
-Independence is paramount for toddlers, who are attempting to do
everything for themselves
-Often use negativism, or negative responses, as they begin to express their
independence
-Ritualism, or maintaining routines and reliability, provides a sense of comfort
for toddlers as they begin to explore the environment beyond those most
familiar to them

A nurse is assessing the psychosocial development of a toddler. The nurse
should recognize that this stage is characterized by which of the following?
A. Imaginary playmates
B. Erikson's stage of initiative vs. guilt
C. Demonstrations of sexual curiosity
D. Negative behaviors characterized by the need for autonomy Right Ans -
D. Negative behaviors characterized by the need for autonomy

Know how a 6-month-old infant expresses pain Right Ans - Younger infant:
Loud cry - increase their cry
Rigid body or thrashing
Local reflex withdrawal from pain stimulus
Expressions of pain (eyes tightly closed, mouth open in a squares shape,
eyebrows lowered and drawn together)
Lack of association between stimulus and pain

Older Infant:
Loud cry

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