Exam 1 Practice Questions- Peds

Which is the nurse's best response to the parents of a neonate with a meningocele who ask what can they expect? "After initial surgery to close the defect, most children experience no neurological dysfunction." "Surgery to close the sac will be postponed until the infant has grown and has enough skin to form a graft." "After the initial surgery to close the defect, the child will likely have motor and sensory deficits." "After the initial surgery to close the defect, the child will likely have future problems with urinary and bowel continence."

"After initial surgery to close the defect, most children experience no neurological dysfunction." *meningocele does NOT have nerve involvement, so most don't have neuro dysfunction.

The nurse is instructing a new breastfeeding mother in the need to provide her pre- mature infant with an adequate source of iron in her diet. Which statement reflects a need for further education of the new mother? "I will use only breast milk or an iron-fortified formula as a source of milk for my baby until she is at least 12 months old." "My baby will need to have iron supplements introduced when she is 4 months old." "I will need to add iron supplements to my baby's diet when she is 2 months old." "When my baby begins to eat solid foods, I should introduce iron-fortified cereals to her diet."

"I will need to add iron supplements to my baby's diet when she is 2 months old." *start iron supplement @ 4 months

Which statement by an infant's mother leads the nurse to believe that she needs further education about the nutritional needs of a 6-month-old? "I will continue to breastfeed my son and will give him rice cereal three times a day." "I will start my son on fruits and gradually introduce vegetables." "I will start my son on carrots and will introduce one new vegetable every few days." "I will not give my son any more than 8 ounces of baby juice per day."

"I will start my son on fruits and gradually introduce vegetables." *start w/ veggies FIRST

A 3-year-old admitted to the hospital with croup has the following vital signs: heart rate 90, respiratory rate 44, blood pressure 100/52, and temperature 98.8°F (37.1°C). The parents ask the nurse if these vital signs are normal. The nurse's best response is: "Your son's blood pressure is elevated, but the other vital signs are within the normal range.." "Your son's temperature is elevated, but the other vital signs are within the normal range.." "Your son's respiratory rate is elevated, but the other vital signs are within the normal range." "Your son's heart rate is elevated, but the other vital signs are within the normal range."

"Your son's respiratory rate is elevated, but the other vital signs are within the normal range." Normal RR = 20-30

A child sustains a traumatic brain injury and is monitored in the pediatric intensive-care unit (PICU). The nurse is using the Glasgow Coma Scale to assess the child. Which items will the nurse assess when using this tool? Select all that apply. 1. Eye opening 2. Verbal response 3. Motor response 4. Head circumference 5. Pulse oximetry

1, 2, 3

A 3-year-old has been diagnosed with cystic fibrosis. The guardians asked the nurse what respiratory symptoms they should expect to see. What will the nurse tell the guardians? Select all that apply. 1. Purulent nasal discharge 2. Frequent infections 3. Mottled nail beds 4. Chronic moist, productive cough 5. Increased fertility

1, 2, 4

The nurse is assessing a toddler's development of communication skills. The nurse recognizes that a toddler communicates in what ways?Select all that apply. 1. Expressive jargon 2. Interpersonal skills and contact with other children 3. Uses all parts of speech 4. Temper tantrums 5. Enjoys talking

1, 2, 4, 5

Which stressor is common in the hospitalized toddler with a chronic disorder? Select all that apply. 1. Fear of painful procedures 2. Self-concept 3. Interruption of normal routines 4. Unfamiliarity of caregivers 5. Isolation

1, 3, 4

While in the pediatrician's office for their child's 12-month well-child exam, the parents ask the nurse for advice on age-appropriate toys for their child. Based on the child's developmental level, which types of toys would the nurse suggest? Select all that apply. 1. Soft toys that can be manipulated 2. Small toys that can pop apart and go back together 3. Jack-in-the-box toys 4. Toys with black and white patterns 5. Push-and-pull toys

1, 3, 5 Both gross and fine motor skills are becoming more developed, and children at this age enjoy toys that can help them refine these skills. They tend to enjoy more colorful toys at this age and are more mobile and thus have less interest in placing toys in their mouths and more interest in toys that can be manipulated.

Which child is at highest risk for requiring hospitalization to treat respiratory syncytial virus (RSV)? 1. A 2-month-old who was born at 32 weeks. 2. A 16-month-old with a tracheostomy. 3. A 3-year-old with a congenital heart defect. 4. A 4-year-old who was born at 30 weeks.

1. A 2-month-old who was born at 32 weeks. *youngest babies @ highest risk, highest cause of hospitalization in first year of life

Which nursing diagnosis is most appropriate for an infant with acute bronchiolitis due to respiratory syncytial virus (RSV)? 1. Activity Intolerance 2. Decreased Cardiac Output 3. Pain, Acute 4. Tissue Perfusion, Ineffective (peripheral)

1. Activity Intolerance

A child is admitted to the hospital with the diagnosis of laryngotracheobronchitis (LTB). Which nursing intervention is the priority for this child? 1. Administer nebulized epinephrine and oral or IM dexamethasone. 2. Administer antibiotics and assist with possible intubation. 3. Swab the throat for a throat culture. 4. Obtain a sputum specimen.

1. Administer nebulized epinephrine and oral or IM dexamethasone. *viral, not bacterial

The mother of a 6-month-old states that since yesterday, the infant cries when anyone touches her arm. Which would be the priority assessment after the airway, breathing, and circulation had been assessed and found stable? 1. Ask the mother if she knows what happened. 2. Assess infant for other signs of potential physical abuse. 3. Prepare for radiological diagnostic studies. 4. Establish intravenous access, and draw blood for diagnostic testing.

1. Ask the mother if she knows what happened.

The nurse is teaching a new mother developmental expectations. Which activity should the nurse expect a newborn to do within the first month of life? 1. Bring hands to eyes and mouth 2. Push up with hands, moving chest up 3. Keep hands in a relaxed position 4. Roll over from back to abdomen

1. Bring hands to eyes and mouth Newborns at one month of age can bring hands to their eyes and mouths, move their heads from side to side when lying on their abdomens, and attempt to lift their heads only when prone. Newborn hands are kept in tight fist position, and the newborn cannot roll over until 4 months of age.

The nurse is caring for a 6-month-old infant diagnosed with meningitis. When the child is placed in the supine position and flexes his neck, the nurse notes he flexes his knees and hips. This is referred to as: 1. Brudzinski sign. 2. Cushing triad. 3. Kernig sign. 4. Nuchal rigidity.

1. Brudzinski sign. -Kernig sign = can't extend leg

A school-age client sustains a basilar skull fracture. Which symptom is a priority for this nurse to assess for when providing care to this client? 1. Cerebral spinal fluid leakage from the nose or ears 2. Headache 3. Transient confusion 4. Periorbital ecchymosis

1. Cerebral spinal fluid leakage from the nose or ears

The nurse is assigned to a child in a spica cast for a fractured femur suffered in an automobile accident. The child's teenage brother was driving the car, which was totaled. The nurse learns that the father lost his job three weeks ago and the mother has just accepted a temporary waitress job. Which nursing diagnosis will the nurse use when planning care for this child and family? 1. Compromised Family Coping Related to the Effects of Multiple Simultaneous Stressors 2. Impaired Social Interaction (Parent and Child) Related to the Lack of Family or Respite Support 3. Interrupted Family Processes Related to Child with Significant Disability Requiring Alteration in Family Functioning 4. Risk for Caregiver Role Strain Related to Child with a Newly Acquired Disability and the Associated Financial Burden

1. Compromised Family Coping Related to the Effects of Multiple Simultaneous Stressors *go w/ your gut!

A lumbar puncture is performed on an infant suspected of having meningitis. Which finding does the nurse expect in the cerebral spinal fluid if the infant has meningitis? 1. Elevated WBC count 2. Elevated RBC count 3. Normal glucose 4. Decreased WBC count

1. Elevated WBC count

The nurse is caring for a toddler client in the postoperative period. Which pain assessment tool is most appropriate for this client? 1. FLACC Behavioral Pain Assessment Scale 2. FACES pain scale 3. Oucher scale 4. Poker-chip tool

1. FLACC Behavioral Pain Assessment Scale *cannot self report pain until after 3 years old

The nurse is assessing a family's effective coping strategies and ineffective defensive strategies. Which family-social-system theory is the nurse using in this assessment of the family? 1. Family-stress theory 2. Family-development theory 3. Family-systems theory 4. Family life-cycle theory

1. Family-stress theory

While assessing the development of a 9-month-old infant, the nurse asks the mother if the child actively looks for toys when they are placed out of sight. Which developmental task is the nurse assessing this infant for? 1. Object permanence 2. Centration 3. Transductive reasoning 4. Conservation

1. Object permanence

The nurse is counseling the parents of a 6-1/2-month-old infant. Which age-appropriate toy is most appropriate for the nurse to suggest to these parents? 1. Soft, fluid-filled ring that can be chilled in the refrigerator 2. Colorful rattle 3. Jack-in-the-box toy 4. Push-and-pull toy

1. Soft, fluid-filled ring that can be chilled in the refrigerator *teething rattle = 3-6 months jack in the box, push/pull toy = 9-12 months

What would the nurse advise the parent of a child with a barky cough that gets worse at night? 1. Take the child outside into the more humid night air for 15 minutes. 2. Take the child to the ER immediately. 3. Give the child an over-the-counter cough suppressant. 4. Give the child warm liquids to soothe the throat.

1. Take the child outside into the more humid night air for 15 minutes.

The nurse is conducting a health surveillance visit with a 6-month-old infant. Which methods are appropriate to monitor the infant's growth pattern since birth? Select all that apply. 1. Weight the infant twice and average together 2. Measure the infant's height 3. Measure the infant's head circumference 4. Determine the infant's body mass index 5. Plot the infant's growth on appropriate chart

1. Weight the infant twice and average together 3. Measure the infant's head circumference 5. Plot the infant's growth on appropriate chart *length, not height *no BMI yet

The nurse is preparing to assess a toddler client. Which activities would gain cooperation from the toddler? Select all that apply. 1. Asking the parents to wait outside 2. Allowing the client to sit in the parent's lap 3. Administering vaccinations prior to the assessment 4. Handing the client a stethoscope while taking the health history 5. Making a game out of the assessment process

2, 4

During a clinic visit, the parents of a 15-month-old ask what disease and injury prevention topics would be appropriate to discuss at this age. Which response by the nurse is the most appropriate? 1. "It's never too early to teach a child to wear a helmet when riding a bicycle." 2. "Teaching simple handwashing is a good topic at this age." 3. "Tell the child over and over to stay away from water unless you are with him." 4. "Tell him firmly 'no' when he tries to cross the street."

2. "Teaching simple handwashing is a good topic at this age."

Which is the nurse's best response to parents who ask what impact asthma will have on the child's future in sports? 1. "As long as your child takes prescribed asthma medication, the child will be fine." 2. "The earlier a child is diagnosed with asthma, the more significant the symptoms." 3. "The earlier a child is diagnosed with asthma, the better the chance the child has of growing out of the disease." 4. "Your child should avoid playing contact sports and sports that require a lot of running."

2. "The earlier a child is diagnosed with asthma, the more significant the symptoms."

The charge nurse on a hospital unit is developing plans of care related to separation anxiety. The charge nurse recognizes that which hospitalized child at highest risk to experience separation anxiety when parents cannot stay? 1. 6-month-old 2. 18-month-old 3. 3-year-old 4. 4-year-old

2. 18-month-old *toddler at highest risk of developing separation anxiety

The nurse is working on parenting skills with a group of mothers. Which mother would need the fewest discipline-related suggestions? 1. Authoritarian 2. Authoritative 3. Indifferent 4. Permissive

2. Authoritative *optimal parenting style, would need least education

The nurse is providing care to an infant in the emergency department. Upon assessment, the infant is noted to have to be experiencing tachypnea, wheezing, retractions, and nasal flaring. The infant is irritability and the parents state the infant has had poor fluid intake for two days. Pulse ox reading is currently at 85 percent on room air. The infant's blood gas is pending. Which diagnosis does the nurse anticipate for this infant? 1. Bronchitis 2. Bronchiolitis 3. Pneumonia 4. Active pulmonary tuberculosis

2. Bronchiolitis

A 5-year-old boy has always been one of the shortest children in class. His mother tells the school nurse that her husband is 6 tall and she is 57. What should the nurse tell the child's mother? 1. He is expected to grow about 3 inches every year from ages 6 to 9 years. 2. He is expected to grow about 2 inches every year from ages 6 to 9 years. 3. He should be seen by an endocrinologist for growth-hormone injections. 4. His growth should be re-evaluated when he is 7 years old.

2. He is expected to grow about 2 inches every year from ages 6 to 9 years.

A 5-year-old is brought to the ER with a temperature of 99.5°F (37.5°C), a barky cough, stridor, and hoarseness. Which nursing intervention should the nurse prepare for? 1. Immediate IV placement. 2. Respiratory treatment of racemic epinephrine. 3. A tracheostomy set at the bedside. 4. Informing the child's parents about a tonsillectomy.

2. Respiratory treatment of racemic epinephrine.

Which of these developmental milestones should the nurse expect to find in children who are between 2 and 3 years old? Select all that apply. 1. Always feeds self 2. Scribbles and draws on paper 3. Kicks a ball 4. Throws ball overhand 5. Goes up and down stairs

2. Scribbles and draws on paper 3. Kicks a ball 5. Goes up and down stairs -feed themselves- 3-4 years old -throw a ball overhand- 4-5 years old

The nurse is counseling the parents of a 13-year-old regarding the behaviors they may encounter after telling the child about their plans to divorce. Which behaviors could the child demonstrate?Select all that apply. 1. Sorrow 2. Skipping school 3. Risk-taking 4. Withdraw from friends and activities 5. Temper tantrums

2. Skipping school 3. Risk-taking

The nurse is preparing to perform a heel stick on a neonate. Which complementary therapy is appropriate for the nurse to use decrease pain during this quick but painful procedure? 1. Swaddling 2. Sucrose pacifier 3. Massage 4. Holding the infant

2. Sucrose pacifier

Which would be an early sign of respiratory distress in a 2-month-old? 1. Breathing shallowly. 2. Tachypnea. 3. Tachycardia. 4. Bradycardia.

2. Tachypnea. 1st sign! Then tachycardia to compensate. Breathing slowly + bradycardia late signs

The nurse is performing a well-child exam on a child who turned 4 years old 3 months ago. What can the nurse ask the child to do to assess appropriate milestones for this age? 1. Jump up and down 2. Throw a ball 3. Stack three or more blocks 4. Draw lines on paper

2. Throw a ball (other activities for younger kids)

A parent of a newborn diagnosed with myelomeningocele asks what is a common long-term complication? The nurse's best response is: 1. Learning disabilities. 2. Urinary tract infections. 3. Hydrocephalus. 4. Decubitus ulcers and skin breakdown.

2. Urinary tract infections. *neurogenic bladder *frequent catheterizations put @ higher risk of UTI

The nurse educator is presenting a lecture about risks to developmental progression. Which items will the educator include in the lecture?Select all that apply. 1. Family support 2. Access to the Internet 3. Recent loss of employment 4. Terminal illness of a family member 5. Hazards within the home environment

3, 4, 5

Which statement by the nurse is most appropriate prior to giving an intramuscular injection to a 2-1/2-year-old child? 1. "We will give you your shot when your mommy comes back." 2. "This is medicine that will make you better. First we will hold your leg, then I will wipe it off with this magic cloth that kills the germs on your leg right here, then I will hold the needle like this and say 'one, two, three . . . go' and give you your shot. Are you ready?" 3. "It is all right to cry, I know that this hurts. After we are done you can go to the box and pick out your favorite sticker." 4. "This is a magic sword that will give you your medicine and make you all better."

3. "It is all right to cry, I know that this hurts. After we are done you can go to the box and pick out your favorite sticker." toddlers- independence. Don't have time/ magical thinking yet. *want to acknowledge feelings and give them something to look forward to :)

The nurse is assessing the pain level in an infant who just had surgery. The infant's parent asks which vital sign changes are expected in a child experiencing pain. The nurse's best response is: 1. "We expect to see a child's heart rate decrease and respiratory rate increase." 2. "We expect to see a child's heart rate and blood pressure decrease." 3. "We expect to see a child's heart rate and blood pressure increase." 4. "We expect to see a child's heart rate increase and blood pressure decrease."

3. "We expect to see a child's heart rate and blood pressure increase." *HR, BP, + RR increase when child is in pain

A parent asks the nurse how it will be determined if their child has respiratory syncytial virus (RSV). Which is the nurse's best response? 1. "We will do a simple blood test to determine whether your child has RSV." 2. "There is no specific test for RSV. The diagnosis is made based on the child's symptoms." 3. "We will swab your child's nose and send that specimen for testing." 4. "We will have to send a viral culture to an outside lab for testing."

3. "We will swab your child's nose and send that specimen for testing."

A new mother is worried about a "soft spot" on the top of her newborn infant's head. The nurse informs her that this is a normal physical finding called the anterior fontanel. At what age will the nurse educate the mother that the soft spot will close? 1. 2 to 3 months of age 2. 6 to 9 months of age 3. 12 to 18 months of age 4. Approximately 2 years of age

3. 12 to 18 months of age

Which nursing action would help foster a hospitalized 3-year-old's sense of autonomy? 1. Let the child choose what time to take the oral antibiotics. 2. Allow the child to have a doll for medical play. 3. Allow the child to administer her own dose of Keflex (cephalexin) via oral syringe. 4. Let the child watch age-appropriate videos.

3. Allow the child to administer her own dose of Keflex (cephalexin) via oral syringe. *autonomy- 3 year old is able to do this by herself

What should parents understand is one of the most common causes of injury and death for a 7-month-old infant? 1. Poisoning. 2. Child abuse. 3. Aspiration. 4. Dog bites.

3. Aspiration.

Which should the nurse do to prevent separation anxiety in a hospitalized toddler? 1. Assume the parental role when parents are not able to be at the bedside. 2. Encourage the parents to always remain at the bedside. 3. Establish a routine similar to that of the child's home. 4. Rotate nursing staff so the child becomes comfortable with a variety of nurses.

3. Establish a routine similar to that of the child's home.

While assessing a 10-month-old African American infant, the nurse notices that the sclerae have a yellowish tint. Which organ system should the nurse further evaluate to determine an ongoing disease process? 1. Cardiac 2. Respiratory 3. Gastrointestinal 4. Genitourinary

3. Gastrointestinal jaundice- possible liver issue

Which is diagnostic for epiglottitis? 1. Blood test. 2. Throat swab. 3. Lateral neck x-ray of the soft tissue. 4. Signs and symptoms.

3. Lateral neck x-ray of the soft tissue.

Which nursing intervention is most appropriate when caring for an infant with a myelomeningocele in the preoperative stage? 1. Placing infant supine to decrease pressure on the sac 2. Appyling a heat lamp to facilitate drying and toughening of the sac 3. Measuring head circumference every shift to identify developing hydrocephalus 4. Appyling a diaper to prevent contamination of the sac

3. Measuring head circumference every shift to identify developing hydrocephalus

A newborn is suspected of having cystic fibrosis. As the child is being prepared for transfer to a pediatric hospital, the mother asks the nurse which symptoms made the practitioner suspect cystic fibrosis. Which response by the nurse is the most appropriate? 1. Steatorrheic stools 2. Constipation 3. Meconium ileus 4. Rectal prolapse

3. Meconium ileus *earliest S/S, other are symptoms but seen in older infant or child with CF

How will a child with respiratory distress and stridor and who is diagnosed with RSV be treated? 1. Intravenous antibiotics. 2. Intravenous steroids. 3. Nebulized racemic epinephrine. 4. Alternating doses of Tylenol and Motrin.

3. Nebulized racemic epinephrine.

After airway, breathing, and circulation have been assessed and stabilized, which intervention should the nurse implement for a child diagnosed with encephalitis? 1. Assist with a lumbar puncture, and give reassurance. 2. Obtain a throat culture, then begin antibiotics. 3. Perform initial and serial neurological assessments. 4. Administer antibiotics and antipyretics.

3. Perform initial and serial neurological assessments.

Which is the best method of distraction for an 8-year-old who is having surgery later today and is NPO? 1. Use the telephone to call friends. 2. Watch television. 3. Play a board game. 4. Read the central line pamphlet he was given.

3. Play a board game.

Which nursing action is most appropriate to gain information about how a child is feeling? 1. Actively attempt to make friends with the child before asking about her feelings. 2. Ask the child's parents what feelings she has expressed in regard to her diagnosis. 3. Provide the child with some paper to draw a picture of how she is feeling. 4. Ask the child direct questions about how she is feeling.

3. Provide the child with some paper to draw a picture of how she is feeling. May be able to express feelings better through drawing

When examining a toddler-age child during a well-child physical, which assessment is the priority? 1. Visual acuity 2. Helmet use 3. Risk of lead exposure 4. Whether household drinking water contains fluorine

3. Risk of lead exposure *poses highest risk

Which assessment of an 18-month-old with burns on his feet would cause suspicion of child abuse? 1. Splash marks on his right lower leg. 2. Burns noted on right arm. 3. Symmetrical burns on both feet. 4. Burns mainly noted on right foot.

3. Symmetrical burns on both feet. *symmetrical injuries red flag for abuse *immersion burn in hot water- if kid stepped in tub w/ one foot and got burnt, would not put other foot in

The nurse is conducting a health promotion class for adolescents. In counseling an adolescent about lifestyle choices, what should the adolescent eliminate in order to decrease the risk of the most preventable cause of adult death? 1. Alcohol use 2. Obesity 3. Tobacco use 4. Cocaine use

3. Tobacco use

A mother asks which developmental milestones she can expect when her baby is 6 months old. Which response by the nurse is the most appropriate? 1. Lifts head momentarily when prone 2. Has well-developed pincer grasp 3. Transfers objects from one hand to the other 4. Rolls from front to back

3. Transfers objects from one hand to the other Incorrect: 1. Lifts head momentarily when prone- 1 month 2. Has well-developed pincer grasp- 12 months 4. Rolls from front to back- 4 months

A preschool-age client is seen in the clinic for a sore throat. In this child's mind, what is the most likely causative agent for the sore throat? 1. Was exposed to someone else with a sore throat. 2. Did not eat the right foods. 3. Yelled at his brother. 4. Did not take his vitamins.

3. Yelled at his brother. *imagination Preschool-age children understand some concepts of being sick but not the cause of illness. They are likely to think that they are sick as a result of something that they have done. They will frequently view illness as punishment.

An 8-day-old was admitted to the hospital with vomiting and dehydration. The newborn's heart rate is 170, respiratory rate is 44, blood pressure is 85/52, and temperature is 99°F (37.2°C). What is the nurse's best response to the parents who ask if the vital signs are normal? 1. "The blood pressure is elevated, but the other vital signs are within normal limits." 2. "The temperature is elevated, but the other vital signs are within normal limits." 3. "The respiratory rate is elevated, but the other vital signs are within normal limits." 4. "The heart rate is elevated, but the other vital signs are within normal limits."

4. "The heart rate is elevated, but the other vital signs are within normal limits." Infant HR = 90-160

The nurse must perform a procedure on a toddler. Which technique is the most appropriate when performing the procedure? 1. Ask the mother to restrain the child during the procedure. 2. Ask the child if it is okay to start the procedure. 3. Perform the procedure in the child's hospital bed. 4. Allow the child to cry or scream.

4. Allow the child to cry or scream. -mother should not restrain (other healthcare worker) -don't ask child- they will say no! -perform procedure in treatment room, want child's room to be a safe place

A nurse is conducting a postoperative assessment on an infant who has just had a ventriculoperitoneal shunt placed for hydrocephalus. Which assessment finding would indicate a malfunction in the shunt? 1. Incisional pain 2. Movement of all extremities 3. Negative Brudzinski sign 4. Bulging fontanel

4. Bulging fontanel

Which physical findings would be of most concern in an infant with respiratory distress? 1. Tachypnea. 2. Mild retractions. 3. Wheezing. 4. Grunting.

4. Grunting. impending respiratory failure :(

While teaching parents of a newborn about normal growth and development, which statement is most appropriate for the nurse to include in the session? 1. Weight should triple by 6 months of age. 2. Weight should double by 1 year of age. 3. Weight should double by 4 months of age. 4. Weight should triple by 1 year of age.

4. Weight should triple by 1 year of age. *should double by 5 months *should quadruple by 2 1/2

Which child is in the greatest need of emergency medical treatment? 3-year-old who has a barky cough, is afebrile, and has mild intercostal retractions. 6-year-old who has high fever, no spontaneous cough, and frog-like croaking. 7-year-old who has abrupt onset of moderate respiratory distress, a mild fever, and a barky cough. 13-year-old who has a high fever, stridor, and purulent secretions.

6-year-old who has high fever, no spontaneous cough, and frog-like croaking. *epiglottitis

A chloride level greater than _____________________ is a positive diagnostic indicator of cystic fibrosis (CF).

60 mEq/L (infants under 3 months = 40 mEq)

Teaching a child with asthma how how to use a peak flow meter. What should nurse include? SATA a. zero the meter before each use b. record average of 3 attempts c. perform 3 attempts d. deliver a long, slow breath into meter e. sit in a chair w/ feet on floors

A, C -record HIGHEST number reading -breathe HARD and FAST into meter -stand upright

Place the nursing assessments of a toddler in the best order. 1. Examination of eyes, ears, and throat 2. Auscultation of chest 3. Palpation of abdomen 4. Developmental assessment

Answer: 4, 2, 3, 1 *least invasive to most invasive

Which of the following actions would a nurse take when caring for a child with bronchiolitis? SATA a. administer oral prednisone b. initiate chest PT and postural drainage c. administer humidified O2 d. suction nasopharynx as needed e. administer oral penicillin

C, D only *steroids and antibiotics don't work- viral infection -chest PT indicated in CF

Which is included in the plan of care for a newborn who has a myelomeningocele? Place the child in the prone position with a sterile dry dressing over the defect. Slowly begin oral gastric feeds to prevent the development of necrotizing enterocolitis. Place the child in the prone position with a sterile dry dressing over the defect. Begin intravenous fluids to prevent dehydration. Place the child in the prone position with a sterile moist dressing over the defect. Slowly begin oral gastric feeds to prevent the development of necrotizing enterocolitis. Place the child in the prone position with a sterile moist dressing over the defect. Begin intravenous fluids to prevent dehydration.

Place the child in the prone position with a sterile moist dressing over the defect. Begin intravenous fluids to prevent dehydration.

The nurse knows that young infants are at risk for injury from shaken baby syndrome (SBS) because: The anterior fontanel is open. They have insufficient musculoskeletal support and a disproportionate head-to-body ratio. They have an immature vascular system with veins and arteries that are more superficial. The nurse knows there is immature myelination of the nervous system in a young infant.

They have insufficient musculoskeletal support and a disproportionate head-to-body ratio.

Which should nurse teach to the parents of a toddler? SATA a. develop food habits that will prevent dental caries b. meeting caloric needs results in an increased appetite c. expression of bedtime fears is common d. expect behaviors associated w/ negativism and ritualism e. annual screenings for PKU are important

a. develop food habits that will prevent dental caries c. expression of bedtime fears is common d. expect behaviors associated w/ negativism and ritualism *DECREASED appetite in toddler years!

Nurse doing developmental screening. Which of the following fine motor skills should be expected @ 10 months? a. grasp the rattle by the handle b. try building a 2 block tower c. use a crude pincer grasp d. place objects into container e. walks w/ one hand held

a. grasp the rattle by the handle c. use a crude pincer grasp 11 months = place objects into container 12 months = builds 2 block tower, walks w/ one hand held

Which of the following findings would the nurse expect in a patient with epiglottitis? SATA a. hoarseness and difficulty speaking b. difficulty swallowing c. low grade fever d. drooling e. dry, barking cough f. stridor

a. hoarseness and difficulty speaking b. difficulty swallowing d. drooling f. stridor NO cough for this (airway obstructed) HIGH fever

Which of the following findings in a CSF sample is consistent with a case of viral meningitis? SATA a. negative gram stain b. normal glucose content c. cloudy color d. decreased WBC e. normal protein content

a. negative gram stain b. normal glucose content e. normal protein content CSF will be clear if viral

Which of the following actions should the nurse take for a patient with suspected meningitis and decreased LOC? a. place patient on NPO status b. prepare patient for liver biopsy c. place patient in dorsal recumbent position d. put the patient in a protective environment

a. place patient on NPO status- *aspiration risk Increase HOB slightly, place on isolation precautions

What should the nurse do to remain professional effectiveness when caring often for children who are dying? SATA a. remain in contact w/ family after loss b. develop a professional support system c. take time off from work d. suggest a hospital representative attend the funeral e. demonstrate sympathy toward family

a. remain in contact w/ family after loss b. develop a professional support system c. take time off from work Incorrect: d. suggest a hospital representative attend the funeral- def attend e. demonstrate sympathy toward family- EMPATHY, no sympathy

Which of the following skills should a 3-year old be able to perform? a. ride a tricycle b. hop on one foot c. jump rope d. throw a ball overhead

a. ride a tricycle- THREE, TRIcycle! 4- hop on one foot, throw ball overhead 5- jump rope

Which of the following should the nurse include in the teaching for administration of a corticosteroid med in a MDI? a. shake device prior to use b. rinse and spit after administration c. inhale slowly with med administration d. exhale quickly after med administration e. wait 30 seconds between puffs

a. shake device prior to use b. rinse and spit after administration c. inhale slowly with med administration -hold breath 5-10 seconds after puff (do NOT exhale quickly) -wait 1 minute between puffs

Which of the following medications would the nurse anticipate administering for a child with CF? SATA a. tobramycin b. loperamide c. fat soluble vits d. albuterol e. dornase alfa

a. tobramycin- antibiotics yes, high chance of respiratory infections c. fat soluble vits- yes, deficient in vits d. albuterol- yes, bronchodilators help open airway and get secretions out e. dornase alfa- yes, thins secretions

Nurse assessing 6 month old infant. Which of following reflexes should be observed? a. Moro b. Plantar grasp c. Stepping d. Tonic neck

b. Plantar grasp- *until 8 months Moro- 4 months Stepping- 4 weeks Tonic neck- 3-4 months

A nurse is caring for a toddler. Which of the following behaviors is an effect of hospitalization? SATA a. believes the experience is punishment b. experiences separation anxiety c. displays intense emotions d. exhibits regressive behaviors e. manifests disturbed body image

b. experiences separation anxiety c. displays intense emotions d. exhibits regressive behaviors Incorrect: a. believes the experience is punishment = preschool child e. manifests disturbed body image = adolescent

Nurse assessing 2 1/2 year old toddler. Which finding should the nurse report to provider? a. height increased by 7.5 cm (3 in) in past year b. head circumference exceeds chest circumference c. anterior and posterior fontanelles closed d. current weight equals 4x birth weight

b. head circumference exceeds chest circumference *should be equal by 1-2 years

Which of the following findings are findings of pain in an infant? SATA a. pursed lips b. loud cry c. lowered eyebrows d. rigid body e. pushes away stimulus

b. loud cry c. lowered eyebrows d. rigid body -mouth open- squarish shape -withdrawal (older child pushes away stimulus)

Which of the following actions should a nurse take when caring for a child receiving a bronchodilator medication by nebulized aerosol therapy? a. instruct child that treatment will last 30 min b. obtain VS prior to procedure c. tell child to take slow deep breaths d. determine if child should use a mask e. attach device to an air source

b. obtain VS prior to procedure c. tell child to take slow deep breaths d. determine if child should use a mask e. attach device to an air source treatment lasts 10-15 mins

Which is true about acetaminophen poisoning? a. nausea begins 24 hr after ingestion b. pallor can appear as early as 2 hr after ingestion c. jaundice will appear in 12 hr if the child is toxic d. children can have 4 g/day of acetaminophen

b. pallor can appear as early as 2 hr after ingestion *nausea, vomiting, sweating, and pallor 2-4 hr after ingestion

Which of the following is true about preschoolers perception of death? a. have no concept of death b. perceive death as temporary c. often regress to earlier stages of behavior d. experience fear related to disease process

b. perceive death as temporary- *have no concept of time

Which of the following interventions are appropriate for a child with asthma? SATA a. perform chest percussion b. place child in upright position c. monitor O2 saturation d. administer bronchodilators e. administer dornase alfa daily

b. place child in upright position c. monitor O2 saturation d. administer bronchodilators *chest PT and dornase alfa indicated in CF

Which of the following skills should an 18-month old be able to perform? SATA a. build a tower with 6 blocks b. throw a ball overhand c. walk up and down stairs d. stand on one foot for a few seconds e. use a spoon w/o rotation

b. throw a ball overhand e. use a spoon w/o rotation 2 years- build tower w/ 6 blocks and walk up and down stairs 2 1/2 years- stand on one foot

Which would be the most appropriate intervention for a 4-year-old brought to the emergency department after ingesting a small watch battery? a. No treatment would be needed; assess and monitor airway, breathing, circulation, and abdominal pain. b. Ask the mother the time of the ingestion; if it was more than 2 hours ago, it will probably pass in his bowel movement. c. Assess and monitor airway, breathing, circulation, and abdominal pain; anticipate admission and prepare for surgical intervention. d. Discuss childproofing measures needed in the home with a 4-year-old child; provide anticipatory guidance concerning other possible poisonous ingestions.

c. Assess and monitor airway, breathing, circulation, and abdominal pain; anticipate admission and prepare for surgical intervention. *batteries need to be removed

Nurse assessing 12 month infant. Which finding should be reported to provider? a. closed anterior fontanel b. eruption of 6 teeth c. birth weight doubled d. birth length increased by 50%

c. birth weight doubled *should be TRIPLED by 1 year (all others in normal range)

Which of the following should the nurse do when preparing to administer meds to a toddler? SATA a. ID toddler by asking caregiver b. tell caregiver to administer med c. calculate safe dosage d. ask toddler to pick a toy to hold during administration e. offer juice after administration

c. calculate safe dosage d. ask toddler to pick a toy to hold during administration e. offer juice after administration *ID toddler with TWO identifiers, can ask them name and DOB

Child's O2 sat reading is 89%. Which action should nurse take first? a. increase O2 flow rate b. encourage child to take deep breaths c. ensure proper placement of sensor probe d. place child in Fowler's position

c. ensure proper placement of sensor probe *assess first

Vital signs of 3 yo. Which should nurse report to provider? a. temp 37.2 C b. heart rate 106 c. respirations 30 d. BP 88/54

c. respirations 30 *above expected reference range

Which of the following is an early sign of hypoxia in an infant? a. nonproductive cough b. hypoventilation c. tachypnea d. nasal stuffiness

c. tachypnea other early signs = tachycardia, restlessness, pallor, evidence of respiratory distress (retractions, accessory muscle use, nasal flaring, adventitious lung sounds)

Which is the first manifestation of sexual maturation in boys? a. pubic hair growth b. vocal changes c. testicular enlargement d. facial hair growth

c. testicular enlargement Testicular enlargement→ Pubic hair →axillary hair →vocal changes.

Nurse assessing child's ears. Which of following should nurse expect? a. light reflex located a 2 o'clock b. tympanic membrane red in color c. bony landmarks are not visible d. cerumen present bilaterally

d. cerumen present bilaterally *light reflex should be from 5-7 o'clock *tympanic membrane should be pearly pink or gray *bony landmarks should be visible

Which of the following should the nurse teach caregivers about separation anxiety? a. often observed in school-aged child b. detachment is stage exhibited in hospital c. results in prolonged issues of adaptability d. kicking a stranger is an example

d. kicking a stranger is an example *physical aggression towards strangers is present in protest stage of separation anxiety

A nurse is planning to administer the flu vaccine to a toddler. Which of the following actions should she take? a. administer subcut in abdomen b. use 20 gauge needle c. divide the med into 2 injections d. place the child in supine position

d. place the child in supine position IM injection = vastus lateralis recommended for infants, young children 22-25 gauge

Which of the following indicates O2 toxicity in children? a. increased BP b. hyperventilation c. decreased PaCO2 d. unconsciousness

d. unconsciousness also: nonproductive cough, substernal pain, nasal stuffiness, N/V, fatigue, headache, sore throat, hypoventilation