Chapter 18 and 21 Peds

Question 1

Tretinoin (Retin-A) is a commonly used topical agent for the treatment of acne. What do nursing considerations with this drug include?

Answer 1

Applying of the medication occurs at least 20 to 30 minutes after washing.

Question 2

What is the usual presenting symptom for testicular cancer?

Answer 2

Hard, painless mass

Question 3

A 13-year-old boy comes to the school nurse complaining of sudden and severe scrotal pain. He denies any trauma to the scrotum. What is the most appropriate nursing action?

Answer 3

Refer him for immediate medical evaluation.

Question 4

A 14-year-old boy is of normal weight, and his parents are concerned about bilateral breast enlargement. The nurse’s discussion of this should be based on what?

Answer 4

Most likely part of normal pubertal development

Question 5

A 15-year-old girl tells the school nurse that she has not started to menstruate yet. Onset of secondary sexual characteristics was about 2 1/2 years ago. The nurse should take which action?

Answer 5

Refer the adolescent for an evaluation.

Question 6

An adolescent girl asks the school nurse for advice because she has dysmenorrhea. She says that a friend recommended she try an over-the-counter nonsteroidal anti-inflammatory drug (NSAID). The nurse’s response should be based on what?

Answer 6

NSAIDs are effective because they inhibit prostaglandins, leading to reduction in uterine activity.

Question 7

What is a major physical risk for young adolescents during pregnancy?

Answer 7

Fetopelvic disproportion is a common problem.

Question 8

The nurse’s role in facilitating successful childrearing in unmarried teenage mothers includes what?

Answer 8

Providing information and feedback about positive parenting skills

Question 9

What is a priority goal in the postpartum care of an adolescent mother?

Answer 9

Prevention of subsequent pregnancies

Question 10

A pregnant 15-year-old adolescent tells the nurse that she did not use any form of contraception because she was afraid her parents would find out. The nurse should recognize what?

Answer 10

This is a frequent reason given by adolescents.

Question 11

An adolescent girl calls the nurse at the clinic because she had unprotected sex the night before and does not want to be pregnant. What should the nurse explain?

Answer 11

Postcoital contraception is available to prevent implantation and therefore pregnancy.

Question 12

An adolescent girl is brought to the hospital emergency department by her parents after being raped. The girl is calm and controlled throughout the interview and examination. The nurse should recognize this behavior is what?

Answer 12

One of a variety of behaviors normally seen in rape victims

Question 13

The nurse has determined that an adolescent’s body mass index (BMI) is in the 90th percentile. What information should the nurse convey to the adolescent?

Answer 13

The adolescent is at risk for becoming overweight.

Question 14

The nurse is teaching a class on obesity prevention to parents in the community. What is a contributing factor to childhood obesity?

Answer 14

Parental overweight

Question 15

During a well-child visit, the nurse plots the child’s BMI on the health record. What is the purpose of the BMI?

Answer 15

To provide a consistent measure of obesity

Question 16

During a well-child visit, the nurse practitioner provides guidance about promoting healthy eating in a child who is overweight. What does the nurse advise?

Answer 16

Slow down eating meals.

Question 17

The middle school nurse is planning a behavior modification program for overweight children. What is the most important goal for participants of the program?

Answer 17

Identify and eliminate inappropriate eating habits.

Question 18

Descriptions of young people with anorexia nervosa (AN) often include which criteria?

Answer 18

Perfectionist

Question 19

What behavior is the nurse most likely to assess in an adolescent with anorexia nervosa (AN)?

Answer 19

Has a marked preoccupation with food

Question 20

During the physical examination of an adolescent with significant weight loss, what finding may indicate an eating disorder?

Answer 20

Erosion of tooth enamel

Question 21

What goal is most important when caring for a child with anorexia nervosa (AN)?

Answer 21

Correct malnutrition.

Question 22

What do nursing responsibilities regarding weight gain for an adolescent with anorexia nervosa include?

Answer 22

Restore body weight to within 10% of the adolescent’s ideal weight.

Question 23

An important distinction in understanding substance abuse is that drug misuse, abuse, and addiction are considered what?

Answer 23

Voluntary behaviors based on psychosocial needs

Question 24

What statement is true about smoking in college students?

Answer 24

Regular cigar use is becoming more common.

Question 25

What strategy is considered one of the best for preventing smoking in teenagers?

Answer 25

Peer-led programs emphasizing the social consequences of smoking

Question 26

Many adolescents use alcohol for self-medication. How does an adolescent view the benefit of alcohol?

Answer 26

Provides a defense against depression

Question 27

What factor is most likely to increase the likelihood that an adolescent will misuse alcohol?

Answer 27

Unconventional behavior

Question 28

What best describes central nervous system (CNS) stimulants?

Answer 28

They can result in strong psychologic dependence.

Question 29

The nurse is caring for an adolescent brought to the hospital with acute drug toxicity. Cocaine is believed to be the drug involved. Data collection by the nurse should include what information?

Answer 29

Mode of administration

Question 30

What statement is true concerning adolescent suicide?

Answer 30

Gay and lesbian adolescents are at a particularly high risk for suicide.

Question 31

What method is the most commonly used in completed suicides?

Answer 31

Firearms

Question 32

What is the most significant factor in distinguishing those who commit suicide from those who make suicidal attempts or threats?

Answer 32

Social isolation

Question 33

An adolescent girl tells the nurse that she is very suicidal. The nurse asks her if she has a specific plan. How should asking about a specific plan be viewed?

Answer 33

An appropriate part of the assessment

Question 34

The nurse is presenting an educational program to a group of parents about differences between anorexia nervosa (AN) and bulimia nervosa (BN) at a community outreach program. What statement by a parent would indicate a need for additional teaching?

Answer 34

“A child with AN is usually sexually active and seeks intimacy, but a child with BN avoids intimacy and is usually not sexually active.”

Question 35

The nurse is teaching an adolescent about acne care. What statement by the adolescent indicates a need for further teaching?

Answer 35

“I will use my antibacterial soap to cleanse my face.”

Question 36

After a treatment plan for acne has been initiated, which time period should the nurse explain to an adolescent before improvement will be seen?

Answer 36

6 to 8 weeks

Question 37

The school nurse suspects a testicular torsion in a young adolescent student. What action should the nurse take?

Answer 37

Refer the adolescent for immediate medical evaluation.

Question 38

The clinic nurse is evaluating an adolescent with menses that have stopped occurring. The nurse understands that which minimum amount of time should the menses be absent after a period of menstruation to be diagnosed as secondary amenorrhea?

Answer 38

6 months

Question 39

An adolescent patient has been diagnosed with a vulvovaginal candidiasis (yeast infection). The nurse expects the health care provider to recommend which vaginal cream?

Answer 39

Miconazole (Monistat)

Question 40

A sexually active adolescent asks the school nurse about prevention of sexually transmitted infections (STIs). What should the nurse recommend?

Answer 40

Use of condoms

Question 41

What statement is true about gonorrhea?

Answer 41

Treatment of all sexual contacts is essential.

Question 42

What statement regarding chlamydial infections is correct?

Answer 42

Both men and women may have asymptomatic infections.

Question 43

What is true about pelvic inflammatory disease (PID)?

Answer 43

It may have devastating effects on the reproductive tract of affected adolescents.

Question 44

It is important that women with anogenital warts caused by the human papillomavirus (HPV) receive adequate treatment because this sexually transmitted infection increases the risk of what?

Answer 44

Cervical cancer

Question 45

The clinic nurse is evaluating a patient with a vaginal infection. The nurse knows that the normal vaginal pH is in which range?

Answer 45

4.0 to 5.0

Question 46

The American Association on Intellectual and Developmental Disabilities (AAIDD), formerly the American Association on Cognitive Impairment, classifies cognitive impairment based on what parameter?

Answer 46

Adaptive skill domains

Question 47

Secondary prevention for cognitive impairment includes what activity?

Answer 47

Newborn screening for treatable inborn errors of metabolism

Question 48

What is a primary goal in caring for a child with cognitive impairment?

Answer 48

Promoting optimum development

Question 49

One of the techniques that has been especially useful for learners having cognitive impairment is called fading. What description best explains this technique?

Answer 49

Gradually reduces the assistance given to the child so the child becomes more independent

Question 50

The parents of a child with cognitive impairment ask the nurse for guidance with discipline. What should the nurse’s recommendation be based on?

Answer 50

Behavior modification is an excellent form of discipline.

Question 51

What intervention is most appropriate to facilitate social development of a child with a cognitive impairment?

Answer 51

Provide peer experiences, such as infant stimulation and preschool programs.

Question 52

The nurse is discussing sexuality with the parents of an adolescent girl who has a moderate cognitive impairment. What factor should the nurse consider when dealing with this issue?

Answer 52

Individuals with cognitive impairment need a well-defined, concrete code of sexual conduct.

Question 53

The mother of a young child with cognitive impairment asks for suggestions about how to teach her child to use a spoon for eating. The nurse should make which recommendation?

Answer 53

Do a task analysis first.

Question 54

A newborn assessment shows a separated sagittal suture, oblique palpebral fissures, a depressed nasal bridge, a protruding tongue, and transverse palmar creases. These findings are most suggestive of which condition?

Answer 54

Down syndrome