Final Exam Peds

The nurse caring for a known seizure child, is aware that in acute seizure episode, nursing priority is to:

Protect the child from injury.

The nurse assesses the neonate immediately after birth. A tracheoesophageal fistula should be suspected if which of the following is present?

An Excessive amount of frothy saliva in the mouth Excessive salivation and drooling

The emergency room nurse has admitted an infant with bulging fontanels, setting sun eyes, and lethargy. Which of the following diagnostic procedures would be contraindicated in this infant?

Lumbar puncture

The ultimate goal of nursing care for a child with Hirschsprung's disease is to:

Maintaining skin integrity, promoting comfort, maintaining fluid balance

When caring for a child with meningitis, it is essential that the nurse evaluate for a positive Brudzinski's sign, which would indicate:

Meningeal irritation

Which action should the nurse take when providing postoperative nursing care to a child after insertion of a ventriculoperitoneal shunt (VP)

Monitoring for increased temperature for postoperative infection

Kevin, who was diagnosed with Hirschsprung's disease has a fever and watery explosive diarrhea. Which of the following would Nurse Joyce do first?

Notify the physical immediately

A child is admitted with acute glomerulonephritis. The nurse would expect the urinalysis during this acute phase to show which of the following?

Proteinuria and/or hematuria

A nurse is caring for a patient with appendicitis. All of the following options are causes of appendicitis. (Select All that Apply).

Obstruction in the appendix seal, lumen, hard fecal mass, parasitic infestation, stenosis, hypoplasia of lymphoid tissue, tumor

The nurse has completed discharge teaching on the dietary regimen of a child with celiac disease. The nurse recognizes that patient education has been successful when the mother states that the child must comply with the gluten-free diet?

Throughout life

A child bas an nasogastric tube (NG) tube after surgery for an acute ruptured appendicitis. The purpose of the NG tube after Gil surgery is which of the following?

To Prevent abdominal distention

A preschooler who had a tracheoesophageal fistula repair at 24 hours of age comes to the clinic for a well-baby check-up. During the visit, the nurse should remind the parents to avoid giving the child foods such as:

Avoid sticky foods, large pieces of food, dry foods.

Children with Duchenne muscular dystrophy usually follow which of the following courses?

Child may have pain due to loss of strength and muscle wasting Progressive deterioration of muscles and death in late teens

The nurse is caring for an infant whose cleft lip was repaired. Important aspects of the infant's postoperative care include which of the following?

Cleansing of suture lines, supine and side-lying positions, and arm restraints

Which of the following can be observed in children with scoliosis and not in children who do not have this condition?

Truncal asymmetry, uneven shoulder and hip height, one sided rib hump, prominent scapula

The nurse is preparing to receive a child from the recovery room. The child has had corrective surgery for clubfoot and is in a cast. The nurse will be prepared to do which of the following interventions upon receiving the child and transferring him to the hospital bed?

Pavlik harness - neurovascular checks every 2 hr for 24 hr, ice and keep elevated for 24 hr, check drainage/bleeding, administer pain meds, monitor for complications (color and temp)

When discharging an infant with acute gastroenteritis from the hospital, the nurse should instruct the parents that if diarrhea recurs, which fluid should they refrain from giving their infant?

Pedialyte, fruity juice, carbonated water, sugary drinks, caffeine, foods high in fat

During the assessment of a child with celiac disease, the nurse would most likely note which of the following physical findings?

Periorbital edema

The nurse is admitting a young child to the hospital because bacterial meningitis is suspected. Which of the following is the major priority of nursing care?

Administer antibiotic therapy as soon as its ordered

Which of the following statements by the family of a child who has a nursing diagnosis of high risk for continued seizure activity most indicates that the family has followed the teaching of the nurse?

"Our child has had a growth spurt so we made an appointment to review the medication to prevent seizures."

The nurse is answering questions for the parents of a newborn who has spina bifida (meningomyelocele). The parents ask when surgery can be done. Which of the following responses by the nurse is most accurate?

"Surgery is usually performed within the first few hours or days of life"

A 2-year old with nephrotic syndrome is admitted to the pediatric unit. The following orders have been written by the doctor in the child's medical record. Which of the following actions is the highest priority for the nurse to perform?

Administer steroids, IV albumin infusions and furosemide

Please match the following medications with the correct letter answer

1. Epinephrine C. 0.01ml/kg 2. Zofran A. 0.15mg/kg 3. Ibuprofen D. 10mg/kg 4. Acetaminophen B. 15mg/kg

A certain pediatric client weighs 85 pounds and is 40 inches tall The client is to receive ibuprofen (100mg/5ml) every 8 hours for fever greater than 102 degrees Fahrenheit. How many millifers does the client receive per dose?

1.93

A nurse is to give Fortaz. 50mg/kg po three times a day to a child who weighs 25.5kg. Fortaz is available in an oral suspension labeled 100mg ml. How many ml would the nurse administer per dose?

12.8

The nurse is to give regular Insulin by continuous IV infusion at 20 units/hour. The solution is 250 ml NS with 100 units of Regular insulin. What ratio on the infusion pump will deliver the correct dose?

50 ml per h

Which patient below is at most risk for increased intracranial pressure (ICP)?

A patient who is admitted with a traumatic brain injury

The nurse places a young child scheduled for a lumbar puncture (I.P) in a side-lying position with the head flexed and knees. drawn up to the chest. The mother asks why the child has to be positioned this way. The nurse explains the rationale for the positioning is that.

Access to the spinal fluid is facilitated

The pediatric nurse assesses the infant and suspects severe dehydration. After receiving doctor's orders, which action would the nurse perform first?

Administer 20ML/KG of normal saline or lactated finger

The parents of an infant with a newly repaired cleft lip question the nurse about the purpose of the Logan's bow. The nurse's best response is?

Both protect (protect lip) & maintain suture line

What should be part of the nurse's teaching plan for a child with epilepsy being discharged on a regimen of phenytoin (Dilantin)?

Brush teeth after meals Instructions about good dental hygiene

A newborn is noted to have an increasing head circumference. The diagnosis of hydrocephalus is confirmed. Which finding should the nurse anticipate?

Bulging anterior fontanel

A two year old is hospitalized with suspected intussusception. The nurse is aware that the finding associated with intussuscepton is:

Carrant Jelly Stools

Before surgery, the priority for nursing care of a newborn with a myelomeningocele is:

Preventing trauma to meningeal sac and preventing infection before surgical repair of defect/ risk for infection. Cover sac w normal saline. Preventing infection

Nurse Nancy is assessing a child with pyloric stenosis; she is likely to note which of the following?

Projectile vomiting

Which of the following organisms is the most common cause of Urinary Tract Infections (UTI) in children?

Escherichia coli (E. Coli) Bacteria

Nurse Elena is handling a 7 year old child who has cystitis. Which of the following would nurse Elena expect when assessing the child?

Dysuria

A child who underwent cleft palate repair has just returned from surgery with elbow restraints in place. The parents question why their child must have the restraints. The nurse would give which of the following as the best explanation to the parents?

Elbow restraints are used postoperatively to keep children hands away from their surgical site

A lumbar puncture is being done on an infant suspected to have meningitis. If the infant has bacterial meningitis. the nurse would expect the cerebral spinal fluid to show: Select all that apply!!!

Elevated WBC, Decreased glucose levels

A neonate is admitted to the NICU to rule out Hirschsprung's disease. The nurse should expect the following clinical manifestations?

Failure to pass meconium (24-48 hours after birth)

Which of the following is a major long term problem for a child with cleft lip and palate?

Faulty definition

You are the nurse assigned to work with a child who has just returned from the recovery room postoperatively for placement of a shunt as a treatment for hydrocephalus. Which of the following positions will you place this child in?

Flat and lying on the unoperated side

A recommendation to prevent neural tube defects is the supplementation of which of the following?

Folic acid, folic acid for all women of childbearing age

When teaching the parent of an infant with Hirschprung's disease who received a temporary colostomy about the types of foods a 1-month old infant will be able to have, which of the following would the nurse recommend?

Formula diet for an infant liquid formula

A child is seen in the pediatric clinic for a variety of symptoms, including periorbital edema that is worse in the morning, loss of appetite and dark colored urine, Which diagnoses should the nurse anticipate?

Glomerulonephritis, nephrotic syndrome

Which of the following is used to monitor brain growth?

Head Circumference measurements

Which of the following symptoms is characteristic of a preschool-age child with a urinary tract infection UTI? (Kidneys and bladder)

High fever, chills, abdominal pain, nausea, vomiting, flank pain, costovertebral angle tenderness, mod- server, dehydration, urgency, dysuria, flank, pain

Mr. and Mrs. Byers chid failed to pass meconium within the first 24 hours after birth. This may indicate which of the following?

Hirschsprung diseases

Which of the following statements by a mother would suggest to the nurse that her child has celiac disease?

His stools are large and smelly.

The mother of an infant with myelomeningocele asks if her baby is likely to have any other defects. The nurse responds based on the understanding that correction of the myelomeningocele is commonly associated with which complication after surgery?

Hydrocephalus Excessive cerebrospinal fluid within cranial activity

The Glasgow Coma Scale consists of an assessment of:

Impaired Consciousness, eyeopening verbal and motor response

The pediatric nurse is examining an adolescent female for possible urinary tract infection, is aware that the Urinary System is composed of which of the following: (Select All that Apply)

Kidneys, ureter, bladder, urethra

A parent asks the school nurse why she should not give her children aspirin for a fever. When the nurse replies that it has to do with the possible risk of a child getting Reye's syndrome while taking aspirin, the parents asks: "What is Reye's syndrome?" Which of the following responses by the nurse would most accurately describe Reye's syndrome?

Life threatening condition following a mild viral illness, in which there is liver enlargement and cerebral edema

Which of the following findings is most often associated with the diagnosis of acute glomerulonephritis?

Little edema, large blood in urine (gross hematuria)

Where will the pain be identified in a patient with appendicitis?

Lower right hand side of abdomen

When positioning a neonate with a repaired myelomeningocele, which of the following positions is most appropriate?

Prone with hip abduction

An infant has been born with an esophageal atresia and tracheoesophageal fistula and is scheduled for surgery. What would the nurse expect to do during the pre operative period?

Risk for aspiration related to regurgitation NPO status, administer iv fluids, antibiotics, and position the babys head elevated 20 to 30 degrees

The Rules of Nine for burns is used in both adult and pediatric clients. In what degree of bums should the rule of nine be used? (Select all that apply)

Second and third degrees burns

Which of the following is most often used to treat clubbed foot?

Serial casting (ponseti method)

When assessing the older child with meningitis, the nurse looks for which manifestation as a frequent first sign of increased intracranial pressure?

Severe headache

A diagnosis of hemophilia A is confirmed in an infant. Which of the following instructions should the nurse provide the parents as the infant becomes more mobile and starts to crawl?

Sew padding into elbows and knees of childs clothes

Which of the following most accurately describes bowel function in children bor with a myelomeningocele?

Some degree of fecal continence can usually be achieved, incontinence with partial control through bowel training

The pediatric nurse is admitting an infant with a history of vomiting and diarrhea. Which physical findings would indicate that the baby is dehydrated? Select all that apply!!!

Sunken fontanelles, tachycardia, and capillary refill greater than 3 seconds poor skin turgor.

The nurse, working with the mother of a baby who was just born with spina bifida (meningomyelocele), will place priority on helping the mother with which one of the following needs

Supportive care Providing emotional support for the mother

A child has been diagnosed with acute glomerulonephritis. Which of the following changes would the nurse expect to see in the child's laboratory reports?

Tea-colored urine

The nurse in the hematology clinic is reviewing laboratory findings for a 2-year-old being treated for anemia. Which assessment finding is the best indication that the treatment is successful?

The child is more active, the reticulocyte count is rising

A parent asks the nurse to explain why children under the age of three are more vulnerable to otitis media. The nurse explains that this is caused by which of the following.

The child's eustachian tubes are shorter, narrower, and horizontal. Leading to more frequent infections.

A child with a diagnosis of nephrotic syndrome enters remission and is to be discharged home. The nurse should instruct the parents about the development of which symptom that would be a cause for concern?

The child's shoes and clothes become tight

If you are walking with a child who begins to have a seizure, you will assist the child to the floor to prevent injury. Which of the following additional actions will you most need to take? Select all that apply!!!

Turn the patient on their side, monitor level of consciousness, remove any nearby object, remove any nearby objects, loosen clothes around neck, monitor respiratory status

When the nurse is assessing an infant suspected of having dysplasia of the hip, which of the following would be most consistent with the first sign and symptoms of that diagnosis?

Uneven gluteal skin creases and a clunk when the ortolani maneuver is performed Asymmetrical buttock creases hip click or pop, hips with limited ROM

A pediatric nurse is teaching a group of adolescents on HIV/AIDS transmission. Which transmission modes would the nurse include in the teaching?

Universal Precautions

A child had a urinary tract infection (UTI) 3 months ago and was treated with an oral antibiotic. A follow up urinalysis revealed normal results. The child has had no other problems until this visit when the child was diagnosed with another UTI. Which is the most appropriate plan?

Urinalysis, urine culture and VCUG

The nurse has taught the parents of a 6-year-old child with a ventriculoperitoneal (VP) shunt to monitor for shunt malfunction. The nurse determines the parents understand the instructions if they state to notify the physician if the child develops which manifestation?

Vomiting,drowsiness & headache

An infant is brought to the emergency department with the following clinical manifestations: poor skin turgor, weight loss. lethargy, depressed anterior fontanelle, and tachycardia. These symptoms are suggestive of which of the following?

Water Depletion, Dehydration

A 7 year old male patient is being evaluated for seizures. While in the child's room talking with the child's parents, the nurse notices that the child appears to be daydreaming. The nurse times this event to be 20 seconds. After 20 seconds, the child appropriately responds and doesn't recall the event. This is known as what type of seizure?

absense

The nurse has admitted a child with a cyanotic heart defect. The nurse would expect to find the initial lab result to show a:

high hemoglobin

The priority nursing focus of care in the preoperative period for the infant with pyloric stenosis focuses on:

improving hydration, improving nutrition and hydration

The nurse assessing an infant finds the following signs and symptoms: sun setting eyes with sclera seen above the iris, a high-pitched cry, bulging fontanel, dilated scalp veins, slight alteration in consciousness, and vomiting. The nurse is aware that these signs and symptoms are most consistent with:

increased intracranial pressure

Chloromycetin 55mg IV every 12 hours for an 8 day old neonate who weighs 3000 grams. The recommended dosage for Chloromycetin is 50mg/kg/day IV divided every 12 hours. Is this dosage safe?

yes