exam 3 peds practice

The nurse instructs an adolescent patient on mixing NPH and regular insulin in the same syringe. Rank the patient teaching in the order the patient should follow to ensure accurate dosing. 1. withdraw the NPH insulin 2. withdraw the regular insulin 3. remove air bubbles for correct dose 4. calculate the combined total volume of insulin 5. inject air equal to the NPH insulin volume into the vial 6. inject air equal to the regular insulin volume into the vial

6. inject air equal to the regular insulin volume into the vial 2. withdraw the regular insulin 3. remove air bubbles for correct dose 4. calculate the combined total volume of insulin 1. withdraw the NPH insulin

The nurse notes the following (see picture below); the nurse would document: *photo is of baby in prone position with expose mass on the back*

Myelomeningocele

The nurse notes the following (see picture below); the nurse would document: *picture is of a baby in the Pavlik Harness*

Pavlik Harness; developmental hip dysplasia

The nurse notes the following (see picture below); the nurse would document: *photo is of girl laying supine with arms at her side and curved up, legs outs, and unconscious*

Tonic seizure

Ordered: 50 units Humulin R insulin in 250 mL of 0.45% sodium chloride to infuse @ 5 units per hr. Calculate the following: a. How many hr will it take to infuse? b. How many mL per hr will be infused?

a. 10 hr b. 25 ml/hr

The nurse is caring for a 3-year-old child with a history of seizures observes the child having a seizure. What information should the nurse document concerning the event? Select all that apply. a. Factors present before seizures started b. Eye position and movement c. Time the seizure started d. Persons in attendance during seizure e. Incontinence of urine or stool f. Number of seizures child has had in the last 48 hours

a. Factors present before seizures started b. Eye position and movement c. Time the seizure started e. Incontinence of urine or stool

Autism is a complex developmental disorder. The diagnostic criteria for autism include delayed or abnormal functioning in which area(s) with onset before age 3 years (select all that apply)? a. Language as used in social communication b. Gross motor development c. Growth below the 5th percentile for height and weight d. Symbolic or imaginative play e. Social interaction

a. Language as used in social communication e. Social interaction d. Symbolic or imaginative play

Hydrostatic reduction is performed in a hospitalized child with a diagnosis of intussusception. Which outcome indicates that the procedure was successful? a. Passage of stool without blood b. Passage of barium in the stool c. Presence of a sausage-shaped abdominal mass d. Visible peristalsis across the abdomen

a. Passage of stool without blood

A preschooler is diagnosed with helminthes. The child's mother is very upset and wants to know how her child could have contracted this illness. After obtaining a detailed history, the nurse identifies all possible transmission modes. Select all modes that apply. a. Playing in the backyard sandbox b. Not washing hands before eating c. Placing hands in the mouth and nail biting d. Skin-to-skin contact with other children e. Scratches from a neighborhood cat

a. Playing in the backyard sandbox b. Not washing hands before eating c. Placing hands in the mouth and nail biting

A child is getting a diagnostic work-up for nephrotic syndrome. Which of the following lab results would the nurse expect to see? a. Proteinuria, hypoalbuminemia, and hypercholesterolemia b. Neutropenia, hematuria, and hypocholesterol c. Hematuria, proteinuria, and hyperalbumenemia d. Proteinuria, hyperalbumenemia, and hypercholesterolemia

a. Proteinuria, hypoalbuminemia, and hypercholesterolemia

An appropriate nursing diagnosis for a child with a cognitive dysfunction who has a limited ability to anticipate danger is: a. Risk for injury b. Deficient knowledge c. Ineffective coping d. Impaired social interaction

a. Risk for injury

A nurse caring for a child wearing a brace to correct scoliosis provides client and family teaching for home care of the brace. Which of these are accurate interventions for this situations? Select all that apply: a. Tell the client to loosen the brace during meals if necessary b. Recommend a shower instead of a bath to stimulate the skin c. Avoid sitting in one position for long periods of time d. Schedule brace wear for waking hours for best therapeutic results e. Wear a 100% cotton T-shirt under the brace to absorb moisture

a. Tell the client to loosen the brace during meals if necessary c. Avoid sitting in one position for long periods of timed. d. Schedule brace wear for waking hours for best therapeutic results

When caring for a child who has a diagnosis of acute glomerulonephritis, which nursing intervention would most likely be included in the child's plan of care? Select all that apply. a. The nurse weighs the child everyday using the same scale b. The nurse administers diuretics c. The nurse encourages ambulation several times a day d. The nurse administers antihypertensives e. The nurse dipsticks the child's urine to test for protein f. The nurse promotes increased fluid intake

a. The nurse weighs the child everyday using the same scale b. The nurse administers diuretics d. The nurse administers antihypertensives e. The nurse dipsticks the child's urine to test for protein

A child with secondary enuresis who complains of dysuria or urgency should be evaluated for which condition? a. UTI b. Hypocalciuria c. Nephrotic syndrome d. Glomerulonephritis

a. UTI

The nurse is creating a care plan for a child with a leg cast. What interventions would be appropriate for the nursing diagnosis of risk for ineffective peripheral tissue perfusion related to pressure from cast? Select all that apply. a. assess foot and toes every 4 hours for color, warmth, and presence of pedal pulses b. educate the child's parents on use of good body mechanics when repositioning the child c. assess capillary refill of toes every 4 hours d. keep leg elevated by a pillow at all times e. remind the parents to not allow the child to put anything in the cast

a. assess foot and toes every 4 hours for color, warmth, and presence of pedal pulses c. assess capillary refill of toes every 4 hours d. keep leg elevated by a pillow at all times

A nurse is assessing an infant who has been vomiting and experiencing diarrhea. Which finding would indicate to the nurse that the infant is experiencing severe dehydration? Select all that apply. a. cool mottled extremities b. sunken fontanels c. bradycardia d. slightly decreased urine output e. pink moist oral mucosa

a. cool mottled extremities b. sunken fontanels c. bradycardia

The nurse is caring for a 10-year-old who has an acute head injury, has a pediatric Glasgow coma score of 9, and is unconscious. Which of following interventions should the nurse include in the child's care plan? a. elevate the head of the bed 15 to 30 ° with head maintained in midline b. perform active ROM and nontherapeautic touch every 8 hours c. maintain an active, stimulating environment d. perfrom chest perfucsison and suctioning every 1 to 2 hours

a. elevate the head of the bed 15 to 30 ° with head maintained in midline

What nursing actions are indicated when the nurse is administering phenytoin (Dilantin) by the intravenous route to control seizures? Select all that apply a. it must be filtered b. occasional blood levels will be assessed c. it must be given in normal saline d. it must be given with D5 1/2 NS e. Dilantin should be given with food because it causes gastrointestinal distress

a. it must be filtered b. occasional blood levels will be assessed c. it must be given in normal saline

On the second day after a surgical repair for a cleft lip, which of the following would be most important? a. preventing crust formation on the suture line b. preventing the infant from vomiting c. keeping the infant in a prone position d. protecting the infant's tongue from swelling

a. preventing crust formation on the suture line

The nurse is working with a group of parents of children who are obese. What action would the nurse include in her teaching plan for this group to aid them in helping their children to lose weight? Select all that apply a. recommend that the child ear all meals at the table with the family b. weigh every day, at the same time, on the same scale, in the same clothing c. set a goal of weight loss of at least 3 to 5 pounds per week d. help the child get involved in an enjoyable activity such as bike riding or swimming for exercise, and make family adventure e. keep a supply of healthy low-calorie snacks around the house, such as carrot sticks and raw vegetables

a. recommend that the child ear all meals at the table with the family d. help the child get involved in an enjoyable activity such as bike riding or swimming for exercise, and make family adventure e. keep a supply of healthy low-calorie snacks around the house, such as carrot sticks and raw vegetables

The nurse provides teaching to the parents of a preschool child before a lumbar puncture. Which information does the nurse include in the parenting teaching about child's behavior related to the procedure? a. remain still during procedure b. lie in semi-Fowler's position c. verbalize complaints of pain d. restrict fluids after the testing

a. remain still during procedure

A nurse is presenting a workshop to parents about autism spectrum disorder (ASD). What does the nurse describe as the difficulties seen with ASD that impair everyday functioning? a. social deficits, communication issues, and restricted behaviors b. recent immunizations, poor communication, and bizarre behavior c. intellectual disability, communication issues, and developmental delays d. poor eye contact, odd behavior, attention deficit hyperactivity disorder

a. social deficits, communication issues, and restricted behaviors

A group of nursing students are reviewing information about celiac disease. The students demonstrate understanding of this disorder when they identify which classic symptoms? Select all that apply. a. Sunken abdomen b. Diarrhea c. Failure to thrive d. Steatorrhea e. Polycythemia f. Constipation

b. Diarrhea c. Failure to thrive d. Steatorrhea f. Constipation

An 8-month-old boy is diagnosed as having cerebral palsy. During physical assessment, the nurse notes which abnormal finding that is common in this disease process? a. He holds his back very straight when in a sitting position b. He has a strong Moro reflex when startled c. He cried when in a ventral suspension position d. He bears weight on both feet when held upright

b. He has a strong Moro reflex when startled

The nurse is assigned to an autism unit @ the local specialty day care center. What characteristics would the nurse anticipate seeing in these children? Select all that apply. a. Loud, long conversations with staff b. Repetitive, rocking behaviors c. Echolalia d. Self-stimulating activities e. Can't remember past events

b. Repetitive, rocking behaviors c. Echolalia d. Self-stimulating activities

Which response by the nurse is accurate when a patient who has been on lamotrigine (Lamictal) for seizure control reports a skin rash and urticaria? a. instruct the patient to decrease the dosage of the medication until the rash disappears b. advise the patient that this adverse effect usually resolves but should be reported to the health care provider c. reassure the patient that this is a common adverse effect of the medication and not to worry d. instruct the patient to discontinue use of drug immediately

b. advise the patient that this adverse effect usually resolves but should be reported to the health care provider

A nurse is applying a cast to a 12-year-old boy with a simple fracture of the radius in the arm. What is most important for the nurse to do when she is finished applying the cast? a. cut a window in the cast over the wrist b. assess the fingers for warmth, pain, and function c. apply a tube of stockinette over the cast d. x-ray the cast to make sure the bones are aligned properly

b. assess the fingers for warmth, pain, and function

A 9-year-old is found to have type 1 diabetes mellitus. The nurse discusses with the child's parents the self-care tasks that may be delegated to the child. In light of the developmental characteristics of the school-age child, which task does the nurse tell the mother may be delegated to the child as long as the child is supervised? a. looking for patterns in the blood glucose level b. choosing the injection site in accordance with the rotation schedule c. drawing up insulin d. recognizing when to test for ketones

b. choosing the injection site in accordance with the rotation schedule

A nurse assesses a client with a head injury who has slowing intellectual functioning, personality changes, and emotional lability. The nurse correlates these findings with which area of the brain? a. temporal lobe b. frontal lobe c. parietal lobe d. thalamus

b. frontal lobe

5. A mother reports that her 4-month-old infant is lethargic, sleeps 18 hours a day, and snores. The nurse recognizes that these signs are characteristics of: a. type 1 diabetes mellitus b. hypothyroidism c. Tay-Sachs disease d. hyperthyroidism

b. hypothyroidism

Developmental delays, self-injury, fecal smearing, and severe temper tantrums un a preschool child are symptoms of a. psychosocial deprivation b. intellectual disability c. separation anxiety d. Down Syndrome

b. intellectual disability

A nurse is preparing a presentation for a group of parents with children diagnosed with type 1 diabetes. The children are all adolescents. What issues would the nurse address related to their developmental level? Select all that apply. a. self monitoring blood glucose levels b. struggle for independence c. body image conflicts d. deficient decision-making skills e. feelings of being different

b. struggle for independence c. body image conflicts d. deficient decision-making skills

The toddler with sudden, severe abdominal pain and currant jelly stools will be treated with a hydrostatic enema. The nurse explains the therapy in this way. The enema will: a. soothe the irritated and inflamed intestine and treat the pain b. unfold the intestine that is pushed in on itself to resolve the obstruction c. push out the stool that is blocking the intestines d. seal the bleeding vessels and stop the mucus production in the stool

b. unfold the intestine that is pushed in on itself to resolve the obstruction

41. An adenosarcoma found in the region of the kidney in a child would most likely be a. leukemia b. wilms tumor c. ewing sarcoma d. osteosarcoma

b. wilms tumor

The nurse is preparing an 18-month-old for discharge following treatment for dehydration secondary to diarrhea. What instruction would the nurse most likely include in the discharge teaching? a. "Provide plenty of 100% fruit juice" b. "Implement clear liquids" c. "Encourage a bland diet" d. "Offer flavored gelatin if hungry"

c. "Encourage a bland diet"

The nurse is monitoring a client for evidence of a hypoglycemic reaction. The client received Humulin R insulin @ 7 AM. The nurse anticipates that the client will need to be most closely monitored for evidence of a hypoglycemic reaction at which time? a. 8:00 PM to Midnight b. 3:00 PM to 6:00 PM c. 9:00 AM to 11:00 AM d. Noon to 3:00 PM

c. 9:00 AM to 11:00 AM

The nurse is caring for a child with a GI disorder and measuring intake and output. The nurse observes that the child is demonstrating symptoms of adequate hydration when he/she has which of the following? Select all that apply. a. Loose stools b. Oral intake c. Fontanelles with normal tention d. Pink and moist mucus membranes e. Adequate skin turgor

c. Fontanelles with normal tention d. Pink and moist mucus membranes e. Adequate skin turgor

Nursing care of the infant who has had a myelomeningocele repair should include a. Securely fastening the diaper b. Measurement of pupil size c. Measurement of head circumference d. Administration of seizure medications

c. Measurement of head circumference

A preschool child has been experiencing severe vomiting for over 24 hours. The child's respiratory rate is currently 10 breaths/min. On which health problem will the nurse focus when caring for this child? a. Overhydration b. Metabolic acidosis c. Metabolic alkalosis d. Hypertonic dehydration

c. Metabolic alkalosis

A histamine-receptor agonist such as famotidine (Pepcid) or rantidine (Zantac) is ordered for an infant with GER. What is the purpse of these drugs? a. Prevent reflux b. Prevent hematemesis c. Reduce gastric acid production d. Increase gastric acid production

c. Reduce gastric acid production

The provider prescribed a urine test for a teenage client, complaining of low back pain. Which is the most important information for the nurse to consider before collecting the urine specimen needed for the test? a. The specimen collection precedes the antibiotic b. The client provides self care of perineum properly c. The urine test requires sending sterile specimen d. Urine aspirate from the collection bag is suitable

c. The urine test requires sending sterile specimen

The nurse in a well-child clinic would suspect a child to have developmental dysplasia of the hip (DDH) when diagnostic characteristics are assessed such as: Select all that apply. a. the foot on the affected side turns out b. a narrow pelvis c. asymmetric gluteal folds d. when legs are flexed, one knee is lower than the other e. the foot on the affected side is cooler

c. asymmetric gluteal folds d. when legs are flexed, one knee is lower than the other

A nurse is providing care to a child with status epilepticus. Which medication would the nurse identify as appropriate for administration? Select all the apply. a. carbamazepine b. gabapentin c. diazepam d. fosphenytoin e. lorazepam

c. diazepam d. fosphenytoin e. lorazepam

Following surgery for pyloric stenosis, an infant should be burped well following feedings primarily to prevent: a. intestinal obstruction b. contaminating flatulence c. pressure on the incision line d. abdominal discomfort

c. pressure on the incision line

The health care provider orders predinsolone 2 mg/kg/day to be given every 8 hours for a child diagnosed with nephrotic syndrome. The child weighs 42 lbs. The medication is available in a solution of 3 mg/mL. What is the amount per dosage in mL for this child? a. 3.8 mL b. 12.6 mL c. 1.2 mL d. 4.2 mL

d. 4.2 mL

Wilms tumor (nephroblastoma) are located in the a. Bone b. Lymphatic system c. Brain d. Kidney

d. Kidney

A 14-year-old child is brought into the emergency room with manifestations consistent with a ruptures appendix. What is the first action that the nurse should take into the care of this child? a. Insert an indwelling urinary catheter b. Position flat in bed c. Apply oxygen d. Place in semi-Fowler's position

d. Place in semi-Fowler's position

What should be the major consideration when selecting toys for a child with an intellectual or developmental disability? a. Age of appropriateness b. Ability to teach useful skills c. Ability to provide exercise d. Safety

d. Safety

The father of a child recently diagnosed with developmental delay is very rude and hostile toward the nurses. This father was cooperative during the child's evaluation a month ago. What is the best explanation for this change in parental behavior? a. The father is exhibiting symptoms of a psychiatric illness. b. The father may be abusing the child. c. The father is resentful of the time he is missing from work for this appointment. d. The father is experiencing a symptom of grief.

d. The father is experiencing a symptom of grief.

The nurse assesses four pediatric patients according to their diagnosis. Which client diagnosis does the nurse associate with the need for a lumbar puncture? a. spina bifida b. increased intracranial pressure c. migraine headaches d. acute bacterial meningitis

d. acute bacterial meningitis