Chapter 18 and 21 Peds Flashcards
Tretinoin (Retin-A) is a commonly used topical agent for the treatment of acne. What do nursing considerations with this drug include?
Applying of the medication occurs at least 20 to 30 minutes after washing.
What is the usual presenting symptom for testicular cancer?
Hard, painless mass
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?
Refer him for immediate medical evaluation.
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?
Most likely part of normal pubertal development
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?
Refer the adolescent for an evaluation.
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?
NSAIDs are effective because they inhibit prostaglandins, leading to reduction in uterine activity.
What is a major physical risk for young adolescents during pregnancy?
Fetopelvic disproportion is a common problem.
The nurse’s role in facilitating successful childrearing in unmarried teenage mothers includes what?
Providing information and feedback about positive parenting skills
What is a priority goal in the postpartum care of an adolescent mother?
Prevention of subsequent pregnancies
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?
This is a frequent reason given by adolescents.
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?
Postcoital contraception is available to prevent implantation and therefore pregnancy.
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?
One of a variety of behaviors normally seen in rape victims
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?
The adolescent is at risk for becoming overweight.
The nurse is teaching a class on obesity prevention to parents in the community. What is a contributing factor to childhood obesity?
Parental overweight
During a well-child visit, the nurse plots the child’s BMI on the health record. What is the purpose of the BMI?
To provide a consistent measure of obesity
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?
Slow down eating meals.
The middle school nurse is planning a behavior modification program for overweight children. What is the most important goal for participants of the program?
Identify and eliminate inappropriate eating habits.
Descriptions of young people with anorexia nervosa (AN) often include which criteria?
Perfectionist
What behavior is the nurse most likely to assess in an adolescent with anorexia nervosa (AN)?
Has a marked preoccupation with food
During the physical examination of an adolescent with significant weight loss, what finding may indicate an eating disorder?
Erosion of tooth enamel
What goal is most important when caring for a child with anorexia nervosa (AN)?
Correct malnutrition.
What do nursing responsibilities regarding weight gain for an adolescent with anorexia nervosa include?
Restore body weight to within 10% of the adolescent’s ideal weight.
An important distinction in understanding substance abuse is that drug misuse, abuse, and addiction are considered what?
Voluntary behaviors based on psychosocial needs
What statement is true about smoking in college students?
Regular cigar use is becoming more common.
What strategy is considered one of the best for preventing smoking in teenagers?
Peer-led programs emphasizing the social consequences of smoking
Many adolescents use alcohol for self-medication. How does an adolescent view the benefit of alcohol?
Provides a defense against depression
What factor is most likely to increase the likelihood that an adolescent will misuse alcohol?
Unconventional behavior
What best describes central nervous system (CNS) stimulants?
They can result in strong psychologic dependence.
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?
Mode of administration
What statement is true concerning adolescent suicide?
Gay and lesbian adolescents are at a particularly high risk for suicide.
What method is the most commonly used in completed suicides?
Firearms
What is the most significant factor in distinguishing those who commit suicide from those who make suicidal attempts or threats?
Social isolation
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?
An appropriate part of the assessment
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?
“A child with AN is usually sexually active and seeks intimacy, but a child with BN avoids intimacy and is usually not sexually active.”
The nurse is teaching an adolescent about acne care. What statement by the adolescent indicates a need for further teaching?
“I will use my antibacterial soap to cleanse my face.”
After a treatment plan for acne has been initiated, which time period should the nurse explain to an adolescent before improvement will be seen?
6 to 8 weeks
The school nurse suspects a testicular torsion in a young adolescent student. What action should the nurse take?
Refer the adolescent for immediate medical evaluation.
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?
6 months
An adolescent patient has been diagnosed with a vulvovaginal candidiasis (yeast infection). The nurse expects the health care provider to recommend which vaginal cream?
Miconazole (Monistat)
A sexually active adolescent asks the school nurse about prevention of sexually transmitted infections (STIs). What should the nurse recommend?
Use of condoms
What statement is true about gonorrhea?
Treatment of all sexual contacts is essential.
What statement regarding chlamydial infections is correct?
Both men and women may have asymptomatic infections.
What is true about pelvic inflammatory disease (PID)?
It may have devastating effects on the reproductive tract of affected adolescents.
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?
Cervical cancer
The clinic nurse is evaluating a patient with a vaginal infection. The nurse knows that the normal vaginal pH is in which range?
4.0 to 5.0
The American Association on Intellectual and Developmental Disabilities (AAIDD), formerly the American Association on Cognitive Impairment, classifies cognitive impairment based on what parameter?
Adaptive skill domains
Secondary prevention for cognitive impairment includes what activity?
Newborn screening for treatable inborn errors of metabolism
What is a primary goal in caring for a child with cognitive impairment?
Promoting optimum development
One of the techniques that has been especially useful for learners having cognitive impairment is called fading. What description best explains this technique?
Gradually reduces the assistance given to the child so the child becomes more independent
The parents of a child with cognitive impairment ask the nurse for guidance with discipline. What should the nurse’s recommendation be based on?
Behavior modification is an excellent form of discipline.
What intervention is most appropriate to facilitate social development of a child with a cognitive impairment?
Provide peer experiences, such as infant stimulation and preschool programs.
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?
Individuals with cognitive impairment need a well-defined, concrete code of sexual conduct.
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?
Do a task analysis first.
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?
Down syndrome
