Ped Unit 2 Assessment Fall
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Free Ped Unit 2 Assessment Fall Questions
A child has been admitted to the inpatient unit to rule out acute Kawasaki disease. A series of laboratory tests have been ordered. Which findings are consistent with this disease? Select all that apply.
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Reduced hemoglobin levels
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Reduced white blood cell count
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Elevated erythrocyte sedimentation rate (ESR)
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Negative C reactive protein levels
- Reduced platelet levels
Explanation
Correct Answers:
Reduced hemoglobin levels
Elevated erythrocyte sedimentation rate (ESR)
Reduced hemoglobin levels:
Anemia (reduced hemoglobin levels) can be seen in Kawasaki disease as part of the acute phase inflammatory response. While this is not the most common lab finding, it is consistent with the disease in some cases, particularly in the early phas
Elevated erythrocyte sedimentation rate (ESR):
An elevated ESR is a hallmark of Kawasaki disease. It is a non-specific indicator of inflammation and is commonly seen during the acute phase of the disease as part of the inflammatory process affecting blood vessels.
Why the other options are incorrect:
Reduced white blood cell count:
Kawasaki disease typically results in an elevated white blood cell count (leukocytosis), not a reduced count. The inflammatory response in Kawasaki disease increases the number of white blood cells to combat the underlying infection or inflammatory process.
Negative C-reactive protein levels:
C-reactive protein (CRP) is an acute-phase reactant and is typically elevated in Kawasaki disease due to the inflammatory process. A negative CRP level would not be expected in this disease
E. Reduced platelet levels:
In the acute phase of Kawasaki disease, platelet levels are typically normal or elevated, not reduced. Elevated platelet count is a common feature in the later stages of the disease, particularly during the subacute phase, as part of the body's inflammatory response.
Summary:
Key lab findings associated with Kawasaki disease include reduced hemoglobin levels and an elevated ESR, reflecting the inflammation and immune response seen in the disease. Leukocytosis and elevated CRP would also be common findings, and platelet levels are typically elevated in the subacute phase rather than reduced.
The nurse is providing developmentally appropriate care for a toddler hospitalized for observation following a fall down the steps. Which of the following measures might the nurse consider when caring for this child? Select all answers that apply.
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Use the en face position when holding the toddler.
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Use a bed for toddlers who have an adult present.
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Avoid leaving small objects that can be swallowed in the bed.
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Explain activities in concrete, simple terms.
- Allow the child to select meals and activities.
- Encourage parents to stay to prevent separation anxiety.
Explanation
Correct Answers:
Avoid leaving small objects that can be swallowed in the bed.
Explain activities in concrete, simple terms.
Allow the child to select meals and activities.
Encourage parents to stay to prevent separation anxiety.
Avoid leaving small objects that can be swallowed in the bed.
Toddlers are naturally curious and tend to explore their environment by putting things in their mouths. Safety is a priority, and leaving small objects within reach of a toddler who may be lying in bed can pose a choking hazard. It is important to keep the environment free of small, swallowable objects to ensure the toddler’s safety.
Explain activities in concrete, simple terms.
Toddlers are at a stage of development where they understand concrete, simple language. Abstract concepts are not yet understood, so explaining activities in straightforward terms, such as "We are going to give you a bath now" or "We are going to put a bandage on your arm," is effective for reducing confusion or anxiety.
Allow the child to select meals and activities.
Giving toddlers some control over their environment helps them feel more secure and confident. Toddlers often struggle with control in a hospital setting, so offering choices (such as picking a meal or a toy to play with) can promote their autonomy and reduce feelings of helplessness or frustration.
Encourage parents to stay to prevent separation anxiety.
Separation anxiety is common in toddlers, and being away from their primary caregiver in an unfamiliar environment like a hospital can heighten anxiety and stress. Encouraging the parents to stay with the child helps provide comfort and reassurance, making the hospital experience less frightening and reducing the risk of emotional distress.
Explanation of Incorrect Answers:
Use the en face position when holding the toddler.
The en face position (where the caregiver faces the child directly, often used for newborns or infants) is not as appropriate for toddlers, who are more mobile and may feel restricted by being held in this way. Instead, toddlers may benefit from being held in a more comfortable position, such as being cradled or sitting in the caregiver’s lap, allowing for a balance between comfort and mobility.
Use a bed for toddlers who have an adult present.
While having an adult present is important, toddlers generally benefit from a more mobile and stimulating environment. They may find it uncomfortable to be confined to a bed for long periods, even with an adult present. A playpen or an area with engaging toys might be more beneficial for toddlers to help reduce boredom and anxiety
Summary:
For a hospitalized toddler, it's important to focus on safety (keeping small objects away), effective communication (simple, concrete explanations), promoting autonomy (offering choices), and reducing anxiety (encouraging parental presence). While en face holding and a bed for toddlers with an adult present may be appropriate in some situations, they are not the most developmentally appropriate measures for toddlers in a hospital setting.
A nurse is providing education to a school-age child who has a new diagnosis of asthma. Which of the following statements should the nurse include in the teaching?
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"Avoid triggers that cause an attack."
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"Take the mast cell stabilizer cromolyn sodium at the first sign of breathing difficulty."
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"Use the peak expiratory flow meter once per week."
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"You should stop playing basketball, but you can swim instead."
Explanation
Correct Answer: "Avoid triggers that cause an attack."
Explanation
Avoiding triggers that cause an asthma attack is a critical component of asthma management. Common triggers include pollen, dust, pet dander, smoke, cold air, and exercise. Avoiding or minimizing exposure can reduce the frequency and severity of asthma attacks.
Why the Other Options Are Incorrect:
"Take the mast cell stabilizer cromolyn sodium at the first sign of breathing difficulty."
Cromolyn sodium is a preventative medication, not a rescue treatment. It should be taken regularly to prevent asthma symptoms, not during an acute attack. Short-acting beta-agonists like albuterol are used for acute symptoms.
"Use the peak expiratory flow meter once per week."
A peak expiratory flow meter (PEFM) should be used daily, not weekly, to monitor lung function and detect changes in airway function before symptoms worsen.
"You should stop playing basketball, but you can swim instead."
Physical activity is encouraged for children with asthma, as long as it is well-controlled. With proper management and pre-exercise medications, most children can safely participate in sports, including basketball.
Key Asthma Management Points to Include:
Medication Use: Take controller medications daily and use rescue inhalers as needed.
Trigger Avoidance: Identify and avoid personal asthma triggers.
PEFM Usage: Monitor daily to track lung function.
Physical Activity: Encourage active play with proper precautions and medications.
Summary:
The most important teaching point for a child with asthma is to avoid triggers that can provoke an asthma attack. Proper use of medications, regular peak flow monitoring, and staying active with precautions can help manage asthma effectively.
The nurse is explaining the effects of heat application for pain relief. Which of the following would the nurse be likely to include as an effect?
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Increased blood flow to the area
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Increased pressure on nociceptive fibers
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Possible release of endogenous opioids
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Altered capillary permeability
Explanation
Correct Answer: Increased blood flow to the area
Explanation
When heat is applied to an area of the body, it causes vasodilation, which increases blood flow to that area. This can help reduce muscle stiffness and improve tissue healing by delivering more oxygen and nutrients to the affected tissues. Heat causes vasodilation, which increases blood flow to the treated area. This enhanced circulation helps relieve pain by promoting the removal of metabolic waste and bringing in fresh nutrients to the area.
Why the Other Options are Incorrect
Increased pressure on nociceptive fibers:
Heat does not directly increase pressure on nociceptive (pain) fibers. Instead, it relaxes muscles and alleviates stiffness, which can reduce pain. Applying heat does not usually create an additional pressure that would activate pain receptors.
Possible release of endogenous opioids:
While heat can promote a feeling of relaxation and relief, the release of endogenous opioids is more commonly associated with certain types of therapeutic interventions, such as acupuncture or intense exercise, not heat application. The primary effect of heat is increasing blood flow and relaxing muscles.
Altered capillary permeability:
Heat can have an effect on capillaries, but its primary action is increasing blood flow, not necessarily altering the permeability of capillaries. Increased capillary permeability is more relevant in the context of inflammation and injury but is not the main mechanism by which heat relieves pain.
Summary:
The application of heat to relieve pain is most likely to cause increased blood flow to the area, which helps with relaxation, reduces muscle stiffness, and promotes healing by delivering more nutrients to the affected tissues.
The nurse is caring for an 8-year-old boy hospitalized for a bone marrow transplant. His parents are in and out of his room throughout the day. Which of the following behaviors of the child would alert the nurse that he is in the second stage of separation anxiety?
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He ignores his parents when they return to his room.
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He cries uncontrollably whenever they leave.
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He forms superficial relationships with his caregivers.
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He sits quietly and is uninterested in playing and eating.
Explanation
Correct Answer: He sits quietly and is uninterested in playing and eating.
Explanation
In the second stage of separation anxiety, known as the despair stage, the child shows signs of emotional withdrawal. The child may stop engaging in activities they usually enjoy, such as playing or eating, and display a lack of interest in their surroundings. This is a sign of deep emotional distress and sadness, as the child is still mourning the absence of their parents but doesn't exhibit the outward behaviors seen in the first stage (protest). This behavior of sitting quietly, uninterested in playing and eating, is characteristic of the despair stage where children feel overwhelmed by the separation but lack the energy to respond actively.
Why the Other Options are Incorrect:
He ignores his parents when they return to his room: As mentioned, this behavior is more consistent with the detachment stage (third stage), where the child shows indifference to the parents upon their return due to prolonged separation.
He cries uncontrollably whenever they leave: This is a hallmark of the protest stage (first stage), where children experience intense distress and attempt to prevent the separation.
He forms superficial relationships with his caregivers: While forming superficial relationships may be seen in some children, this is not the defining feature of the despair stage. Instead, emotional withdrawal and apathy are more prominent at this stage.
Summary:
In the despair stage of separation anxiety, the child typically becomes withdrawn, shows signs of sadness, and might not be interested in activities like playing or eating.
The nurse is teaching the student nurse the sequence for performing the assessment techniques during a physical examination. What is the appropriate order?
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Inspection, palpation, percussion, auscultation
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Inspection, percussion, palpation, auscultation
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Palpation, percussion, inspection, auscultation
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Inspection, auscultation, palpation, percussion
Explanation
Correct Answer: Inspection, palpation, percussion, auscultation.
Explanation
The proper order for performing the assessment techniques during a physical examination follows a systematic approach to ensure the accuracy and effectiveness of the assessment:
Inspection: This is the first step and involves visually examining the patient. The nurse observes the patient’s overall appearance, posture, skin, and any visible signs of abnormalities or distress. This step is non-invasive and should be done before any other techniques to get an initial impression.
Palpation: After inspection, the nurse uses their hands to palpate (feel) the body, which can help identify areas of tenderness, swelling, or masses. Palpation is typically done gently and systematically to assess for any physical abnormalities.
Percussion: Percussion involves tapping on the body surface to assess underlying structures, such as the lungs or abdomen, to evaluate size, consistency, and presence of fluid. It helps in evaluating resonance, dullness, or tympany.
Auscultation: Finally, auscultation (listening to body sounds using a stethoscope) is performed. This is done after the other techniques because the sounds heard through auscultation can be influenced by movement or palpation, so it is best to perform it last to avoid altering the sound.
Why the Other Options are Incorrect:
Inspection, percussion, palpation, auscultation: This order is incorrect because palpation should come before percussion to avoid altering percussion sounds with any pressure or manipulation.
Palpation, percussion, inspection, auscultation: This order is incorrect because inspection is the first step and should be performed before palpation, percussion, or auscultation.
Inspection, auscultation, palpation, percussion: This order is not optimal. Although auscultation can be performed early in some cases (e.g., abdominal exams), it is typically done after palpation and percussion in most other situations, especially when assessing the lungs or heart.
Summary:
The correct order for assessment techniques is Inspection, palpation, percussion, and auscultation. This sequence allows for a thorough and systematic examination of the patient, ensuring the most accurate and least disruptive results.
Which of the following are common manifestations and potential consequences of an adolescent's feelings of invulnerability? (Select All that Apply.)
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Increased risk-taking behaviors
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Greater incidence of accidental injuries
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Reduced mental health issues
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Improved social relationships
- Higher likelihood of substance abuse
- Enhanced academic performance
Explanation
Correct Answers:
Increased risk-taking behaviors
Greater incidence of accidental injuries
Higher likelihood of substance abuse
Rationale:
Increased risk-taking behaviors:
Adolescents often feel invulnerable and may believe that they are immune to the consequences of risky behaviors, such as reckless driving, unsafe sexual activity, or experimenting with drugs or alcohol.
Greater incidence of accidental injuries:
This feeling of invulnerability can lead to unsafe behavior, increasing the likelihood of accidents and injuries, such as those caused by risky sports or dangerous activities.
Higher likelihood of substance abuse:
A sense of invulnerability can make adolescents more likely to engage in substance abuse, as they may feel that they are not at risk for the long-term health consequences that substances can cause.
Why the other options are less likely:
Reduced mental health issues:
Feelings of invulnerability are more often associated with an increased risk of mental health issues, as adolescents may deny the impact of stress, anxiety, or depression, leading to a lack of help-seeking behavior.
Improved social relationships:
Invulnerability is more likely to result in social conflict due to risky behaviors and poor decision-making rather than improved relationships.
Enhanced academic performance:
Feelings of invulnerability tend to lead to distraction and a lack of focus, which can negatively impact academic performance rather than enhancing it.
Summary:
The correct choices are increased risk-taking behaviors, greater incidence of accidental injuries, and higher likelihood of substance abuse.
The nurse is preparing the parents and the child with Kawasaki disease for discharge from the hospital. What will the nurse teach the family about home care? Select all that apply.
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"Aspirin therapy should be given daily for several months as prescribed."
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"The child should not receive any live vaccines for 6 months."
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"Schedule the prescribed cardiac evaluations."
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"Allow the child to be active daily to increase joint range of motion."
- "Take the child's temperature twice daily."
Explanation
Correct Answer:
"Aspirin therapy should be given daily for several months as prescribed."
"The child should not receive any live vaccines for 6 months."
"Schedule the prescribed cardiac evaluations."
Explanation
"Aspirin therapy should be given daily for several months as prescribed."
Children with Kawasaki disease are often treated with high-dose aspirin therapy during the acute phase and are typically continued on low-dose aspirin for several months to help reduce the risk of coronary artery aneurysms. It is essential for parents to follow the prescribed regimen and not discontinue it early.
"The child should not receive any live vaccines for 6 months."
Children who have received intravenous immunoglobulin (IVIG) as part of their treatment for Kawasaki disease should avoid live vaccines for 6 months after receiving the IVIG. This is to ensure that the immunoglobulin does not interfere with the efficacy of live vaccines, such as the MMR (measles, mumps, rubella) or varicella vaccines.
"Schedule the prescribed cardiac evaluations."
Kawasaki disease can lead to coronary artery changes, and regular cardiac follow-up is essential to monitor for any complications, including coronary artery aneurysms. The nurse should emphasize the importance of cardiac evaluations as prescribed by the healthcare provider to assess heart function and vascular health.
Why the Other Options are Incorrect:
"Allow the child to be active daily to increase joint range of motion."
While some joint pain and stiffness can occur as a result of Kawasaki disease, it is not always appropriate to encourage unrestricted activity right away. The child may need rest and a more gradual return to activity. The goal is to avoid overexertion and further joint damage. Activity should be moderated based on the child's condition and any residual symptoms.
"Take the child's temperature twice daily."
After the acute phase of Kawasaki disease, the need for regular temperature monitoring is not typically emphasized unless the child shows signs of a fever or infection. Parents should be instructed to monitor for signs of infection (such as fever) and to report any concerning symptoms to the healthcare provider. However, routine temperature checks twice daily are not a typical requirement for home care after the child is discharged, unless directed by the provider.
Summary:
Parents should be instructed to continue aspirin therapy, avoid live vaccines for 6 months, and schedule cardiac evaluations. Joint activity should be carefully managed, and regular temperature checks are not necessary unless there are specific concerns. Emphasis should be placed on following the prescribed care plan to monitor for complications and support recovery.
The nurse is implementing the plan of care for a child with acute rheumatic fever. What treatment(s) would the nurse expect to administer if prescribed? Select all that apply.
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penicillin
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corticosteroids
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nonsteroidal anti-inflammatory drugs
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digoxin
- intravenous immunoglobulin
Explanation
Correct Answer(s):
Penicillin
Corticosteroids
Nonsteroidal anti-inflammatory drugs (NSAIDs)
Explanation
Penicillin
Penicillin is commonly prescribed to treat acute rheumatic fever (ARF) to eradicate group A streptococcus bacteria (the causative organism of streptococcal throat infections), which can trigger the autoimmune reaction leading to ARF. Penicillin or a similar antibiotic is used as prophylactic treatment to prevent further infections and reduce the risk of rheumatic heart disease (RHD).
Corticosteroids
Corticosteroids (e.g., prednisone) may be prescribed to help manage inflammation and reduce symptoms, especially in cases with severe carditis or arthritis. They are used to control inflammation and prevent further damage to tissues, such as the heart valves.
Nonsteroidal Anti-inflammatory Drugs (NSAIDs)
NSAIDs (e.g., aspirin or ibuprofen) are often prescribed to treat the inflammation and pain associated with acute rheumatic fever, especially in the presence of arthritis or pericarditis. NSAIDs help alleviate symptoms like joint pain and inflammation.
Why the Other Options Are Incorrect
Digoxin
Digoxin is a medication that is used to treat heart failure and arrhythmias but is not typically indicated for the treatment of acute rheumatic fever. While ARF can lead to carditis and rheumatic heart disease, digoxin is not used to manage the primary symptoms of ARF.
Intravenous Immunoglobulin (IVIG)
IVIG is not typically used to treat acute rheumatic fever. It is sometimes used in other autoimmune conditions, such as Kawasaki disease, but not as a standard treatment for ARF. The main treatments for ARF focus on controlling inflammation (via NSAIDs and corticosteroids) and preventing further infections (via penicillin).
Summary:
When treating a child with acute rheumatic fever, the nurse would expect to administer penicillin to treat the infection, corticosteroids to manage severe inflammation, and NSAIDs to alleviate pain and inflammation associated with the disease. Digoxin and IVIG are not typically used for treating ARF.
The nurse is providing anticipatory teaching to parents about pubescent changes in school-aged and young adolescent girls. Which of the following changes should the nurse include in the teaching? (Select All that Apply.)
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Vocal changes
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Decreased height
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Breast development
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Menarche
- Increased axillary hair
Explanation
Correct Answers:
Breast development
Menarche
Increased axillary hair
Explanation
During puberty, a series of physical changes occur in both boys and girls, but the changes in girls are particularly noticeable. For school-aged and young adolescent girls, the following are common changes:
Breast development: One of the first visible signs of puberty in girls is the development of breasts. This typically begins between the ages of 8 and 13 and is an important part of sexual maturation.
Menarche: The onset of menstruation, known as menarche, typically occurs between ages 9 and 15, marking another significant milestone in pubertal development for girls.
Increased axillary hair: The growth of hair in the underarm (axillary hair) is another common change that occurs during puberty, usually after the onset of breast development.
Why the Other Options are Incorrect:
Vocal changes: Vocal changes (such as a deepening of the voice) are more commonly seen in boys during puberty due to the growth of the larynx. Girls may experience a slight change in voice, but it is typically not as pronounced as in boys.
Decreased height: Height increases during puberty as growth spurts occur. Puberty generally leads to a significant increase in height, particularly in early adolescence, before the growth plates close and height growth slows down in later adolescence.
Summary:
For school-aged and young adolescent girls, the nurse should include breast development, menarche, and increased axillary hair in the anticipatory teaching. These are key physical changes associated with puberty in girls.
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Comprehensive Guide for Ped Unit 2 Assessment Fall
- Realistic and Exam-Focused Practice Questions: Our multiple-choice questions, including case-based scenarios, are carefully designed to mirror the format of the Ped Unit 2 Assessment Fall exam. These questions will help you develop critical thinking and application skills, making you feel confident and prepared for the exam.
- Detailed Rationales for Every Question: Each question comes with a clear, detailed explanation that breaks down key concepts, helping reinforce your understanding and ensuring you are ready for the comprehensive nature of the exam.
- Aligned with 2025 Standards: Our content is updated to reflect the latest guidelines and best practices for 2025, so you’ll be well-prepared for the evolving requirements of the Ped Unit 2 Assessment Fall exam.
- Practice Questions: In-depth coverage of important topics, such as core theories, application strategies, and exam-specific concepts. Questions are designed to replicate the real exam’s format, helping you focus on the right areas.
- Core Concept Reviews: Clear and concise summaries of major concepts relevant to Ped Unit 2, including theory applications, problem-solving techniques, and critical thinking strategies. You’ll get detailed reviews to strengthen your understanding and improve exam performance.
- Case Studies: Real-world scenarios that encourage you to apply your knowledge and decision-making skills, enhancing your ability to handle complex situations and improve your performance in the exam.
- Test-Taking Strategies: Practical tips on how to manage your time, tackle challenging question formats, and optimize your exam performance. Stress management advice, effective study techniques, and ways to improve your overall exam strategy to help you approach the Ped Unit 2 Assessment Fall with confidence.
Why This Guide Will Help You Succeed:
- Comprehensive Coverage: All major topics are included to ensure you are fully prepared for every section of the Ped Unit 2 Assessment Fall exam.
- Evidence-Based Approach: Every practice question and review is based on the most current standards and best practices, ensuring you have the most relevant materials for your preparation.
- Focused on Success: This guide will help sharpen your knowledge, boost your confidence, and ensure that you master the key areas needed for success on the Ped Unit 2 Assessment Fall exam.
Pediatric Unit 2 Assessment (Fall 2) Study Notes
I. Introduction to Pediatric Health Assessment
Pediatric health assessment is a systematic approach to evaluating the physical, developmental, and psychosocial well-being of children from infancy through adolescence. It involves gathering subjective and objective data to identify health issues, monitor growth and development, and plan appropriate interventions.
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Early Detection: Identifies potential health problems early, allowing for timely intervention.
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Growth Monitoring: Tracks physical development to ensure children are growing appropriately.
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Developmental Surveillance: Assesses milestones to detect delays or abnormalities.
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Family Engagement: Involves families in the healthcare process, fostering collaboration.
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Subjective Data: Information provided by the child or caregivers, including medical history, symptoms, and family concerns.
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Objective Data: Measurable data obtained through physical examination and diagnostic tests.
II. Growth and Development
Understanding normal growth patterns and developmental milestones is crucial for assessing pediatric health.
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Height and Weight: Regular measurements help assess nutritional status and growth trends.
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Head Circumference: Monitored in infants to assess brain growth and development.
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Chest Circumference: Compared with head circumference to evaluate thoracic development.
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Motor Skills: Progress from reflexive movements to coordinated actions.
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Language Development: From cooing to complex speech.
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Social Skills: Development of interaction abilities and emotional responses.
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Genetics: Inherited traits affecting growth patterns.
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Nutrition: Adequate nutrition supports optimal development.
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Environment: Safe and stimulating environments promote healthy growth.
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Health Conditions: Chronic illnesses can impact development.
III. Pediatric Physical Examination
A thorough physical examination is essential for assessing a child's health status.
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Appearance: Observing the child's general state of health.
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Behavior: Assessing activity level and responsiveness.
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Posture and Movement: Noting any abnormalities in posture or movement.
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Temperature: Monitoring for fever or hypothermia.
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Pulse: Assessing heart rate and rhythm.
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Respirations: Evaluating breathing patterns and effort.
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Blood Pressure: Important for detecting hypertension or hypotension.
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Inspection: Looking for abnormalities in head shape or size.
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Palpation: Checking for tenderness or masses.
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Neck Mobility: Assessing range of motion and signs of stiffness.
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Auscultation: Listening for heart sounds and murmurs.
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Peripheral Pulses: Checking for strength and symmetry.
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Capillary Refill: Evaluating circulatory efficiency.
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Inspection: Observing chest shape and respiratory effort.
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Auscultation: Listening for breath sounds and wheezing.
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Percussion: Assessing lung fields for abnormalities.
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Inspection: Observing abdomen for distension or scars.
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Palpation: Checking for tenderness or masses.
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Auscultation: Listening for bowel sounds.
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Inspection: Looking for deformities or asymmetry.
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Palpation: Checking for tenderness or swelling.
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Range of Motion: Assessing joint flexibility.
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Mental Status: Evaluating alertness and orientation.
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Cranial Nerves: Testing function of cranial nerves.
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Reflexes: Checking for appropriate reflex responses.
IV. Pediatric Pain Assessment
Accurate pain assessment is vital for appropriate management in children.
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Behavioral Signs: Crying, facial grimacing, restlessness.
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Physiological Signs: Increased heart rate, blood pressure changes.
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Self-Report: Using age-appropriate tools for children to express pain.
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FLACC Scale: Face, Legs, Activity, Cry, Consolability.
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Wong-Baker FACES Scale: Uses facial expressions to indicate pain levels.
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Numeric Rating Scale: For older children who can understand numbers.
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Pharmacological: Medications like acetaminophen or ibuprofen.
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Non-Pharmacological: Distraction techniques, relaxation exercises.
V. Pediatric Immunizations
Immunizations are critical in preventing infectious diseases in children.
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Birth to 6 Years: Vaccines for hepatitis B, DTaP, Hib, IPV, MMR, varicella, and others.
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7 to 18 Years: Tdap booster, HPV, meningococcal, and annual influenza vaccines.
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Injection Sites: Common sites include the vastus lateralis and deltoid muscles.
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Techniques: Proper needle size and angle to minimize discomfort.
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Common Side Effects: Redness, swelling, mild fever.
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Serious Reactions: Anaphylaxis, though rare, requires immediate attention.
VI. Pediatric Nutrition
Proper nutrition is essential for growth and development in children.
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Infants: Breast milk or formula provides complete nutrition.
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Toddlers and Preschoolers: Balanced diet with appropriate portion sizes.
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School-Age Children: Increased caloric intake to support growth.
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Dietary History: Reviewing food intake patterns.
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Anthropometric Measurements: Monitoring weight, height, and BMI.
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Laboratory Tests: Checking for deficiencies or imbalances.
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Obesity: Linked to sedentary lifestyle and poor dietary habits.
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Malnutrition: Can result from inadequate intake or absorption issues.
VII. Pediatric Respiratory Disorders
Respiratory issues are common in pediatric populations and require prompt assessment.
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Asthma: Chronic inflammation leading to airway constriction.
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Bronchiolitis: Viral infection causing inflammation of the small airways.
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Pneumonia: Infection of the lungs leading to inflammation and consolidation.
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Wheezing: High-pitched
Ped Unit 2 Assessment Fall Practice Question
TOPIC: Pediatric Nutrition and Feeding Disorders
Question 1:
A 4-year-old male with a history of severe food allergies (peanuts and shellfish) presents for a routine check-up. His mother expresses concern about his limited food choices due to these allergies and reports that he has been refusing meals at daycare. The child is underweight, in the 5th percentile for weight and 25th percentile for height. He tends to prefer starchy foods like potatoes and pasta but avoids fruits, vegetables, and protein sources due to texture aversions. His mother is worried that his picky eating may affect his growth. Recent blood tests reveal mild anemia and vitamin D deficiency. Which nursing intervention should take priority in his care plan?
A) Educate the parents about the importance of introducing a variety of foods, including fruits and vegetables.
B) Recommend a referral to a pediatric dietitian to address the child’s nutritional deficiencies.
C) Assess the child’s feeding behaviors and the parents’ understanding of allergy-safe nutrition.
D) Encourage the child to eat more starchy foods to increase calorie intake.
Correct Answer: C) Assess the child’s feeding behaviors and the parents’ understanding of allergy-safe nutrition.
Why C (Assess the child’s feeding behaviors and the parents’ understanding of allergy-safe nutrition) is Correct:
The priority intervention is to assess the child’s feeding behaviors and the parents’ understanding of allergy-safe nutrition. The child’s picky eating and restricted diet may be exacerbated by a lack of knowledge about safe food choices due to allergies. By assessing both the child’s feeding patterns and the parents’ understanding, the nurse can identify any barriers to improving the child's diet and provide appropriate education to ensure that nutritional needs are met while avoiding allergens. This foundational understanding will allow for targeted interventions to improve the child’s growth and overall health.
Why the Other Options Are Incorrect:
A) Educate the parents about the importance of introducing a variety of foods, including fruits and vegetables:
While education is necessary, it is secondary to first assessing the feeding behaviors and understanding of allergy-safe nutrition. If the parents are not aware of how to safely introduce variety while avoiding allergens, education could be ineffective.
B) Recommend a referral to a pediatric dietitian to address the child’s nutritional deficiencies:
Referring to a dietitian is an important step, but the first priority is assessing the current feeding practices and the parents' understanding of nutrition. This allows the nurse to identify areas where the family may need immediate guidance, which could help resolve the nutritional deficiencies in the short term.
D) Encourage the child to eat more starchy foods to increase calorie intake:
Encouraging more starchy foods may help with calorie intake, but it does not address the underlying issue of poor dietary variety, food aversions, and nutrient deficiencies. A more holistic approach, including improving food diversity and addressing allergies, should be prioritized.
Summary:
In pediatric nutrition, assessing the child’s feeding behaviors and the parents’ understanding of allergy-safe nutrition is the priority when addressing concerns like picky eating and nutritional deficiencies. Once these are understood, targeted interventions, including dietitian referrals and education about food variety and safe food choices, can be implemented to support the child’s growth and overall health.
TOPIC: Pediatric Nutrition and Feeding Disorders
Question 2:
A 3-year-old female is brought to the clinic by her parents due to concerns about her poor eating habits. She is in the 10th percentile for weight and the 25th percentile for height. The parents report that she has become increasingly picky with her food choices, refusing most vegetables, fruits, and protein-rich foods, and she has developed a preference for sweetened snacks and sugary drinks. Her parents are worried that her eating habits may be impacting her growth and overall health. The child’s recent blood work shows low iron levels. Which nursing intervention should take priority in her care plan?
A) Educate the parents on the importance of limiting sugary snacks and drinks and offering healthier alternatives.
B) Assess the child’s growth and development, including signs of nutritional deficiencies such as fatigue or pallor.
C) Refer the child to a pediatric specialist for a more detailed evaluation of her eating behaviors.
D) Encourage the parents to offer the child more frequent meals and snacks to increase calorie intake.
Correct Answer: B) Assess the child’s growth and development, including signs of nutritional deficiencies such as fatigue or pallor.
Why B (Assess the child’s growth and development, including signs of nutritional deficiencies) is Correct:
The priority intervention is to assess the child’s growth and development, particularly signs of nutritional deficiencies. The child’s low iron levels and picky eating habits may suggest deficiencies in essential nutrients. By assessing her physical status and growth, the nurse can identify whether there are visible signs of iron deficiency or other nutrient-related health concerns, which will guide further interventions. This step helps prioritize immediate health concerns before implementing dietary changes or education.
Why the Other Options Are Incorrect:
A) Educate the parents on the importance of limiting sugary snacks and drinks and offering healthier alternatives:
While it is important to address the child’s preference for sugary snacks, this intervention follows after assessing the child’s current nutritional status and identifying immediate health concerns. Education without first assessing the child’s development may not be as effective.
C) Refer the child to a pediatric specialist for a more detailed evaluation of her eating behaviors:
Referral to a specialist may be appropriate in some cases, but the priority is to first assess the child’s health and growth. This initial assessment will help determine if a specialist referral is necessary or if the issue can be managed with basic interventions, such as improving nutrition and identifying deficiencies.
D) Encourage the parents to offer the child more frequent meals and snacks to increase calorie intake:
Increasing meal frequency may help with calorie intake, but it does not address the root causes of the child’s picky eating and nutritional deficiencies. The focus should first be on assessing the child’s overall health, growth, and development before suggesting dietary changes.
Summary:
The priority for this child is to assess her growth and development to identify any signs of nutritional deficiencies. Once her current health status is understood, the nurse can then provide education on healthy eating habits, suggest appropriate changes to her diet, and address specific deficiencies like iron deficiency.
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