lippincott peds exam 3

After a plaster cast has been applied to the arm of a child with a fractured right humerus, the nurse completes discharge teaching. The nurse should evaluate the teaching as successful when the mother agrees to seek medical advice if the child experiences which symptom? 1.inability to extend the fingers on the right hand 2.vomiting after the cast is applied 3.coolness and dampness of the cast after 5 hours 4.fussiness and reports that the cast is heavy

1

An adolescent client reports right lower quadrant pain, nausea, vomiting, and a low-grade fever for the past 12 hours. A physical examination reveals rebound tenderness and a positive psoas sign. Based on these findings, what should the nurse suspect? 1. appendicitis 2. pancreatitis 3. cholecystitis 4. constipation

1

An adolescent client scheduled for an emergency appendectomy is to be transferred directly from the emergency department to the operating room. Which statement by the client should the nurse interpret as most significant? 1. all of a sudden it does not hurt at all 2. the pain is centered around my navel 3. i feel like i am going to throw up 4. it hurts when you press on my stomach

1

A 5-year-old is admitted to the pediatric unit with diagnosis of possible intussusception. Which assessment data supports this diagnosis? Select all that apply. 1. currant jelly stools 2. dirrahea 3. abdominal pain 4. tarry black stools 5. abdominal distention

1,3,5

A student with type 1 diabetes tells the nurse she is feeling light-headed. The student's blood sugar is 60 mg/dL (3.3 mmol/L). Using the 15-15 rule, what should the nurse do to treat the blood glucose? 1. adminster 15 mL of juice and give another 15 mL in 15 mins 2. administer 15 g of carbodydrate and retest the blood sugar in 15 mins 3. administer 15 g of carb and 15 g of protein 4. administer 15 oz of juice and retest in 15 mins

2

The nurse is admitting a 12-year-old child diagnosed with osteomyelitis of the left femur. What will be the nurse's first action for the child's care? 1. administer IV antibiotics as ordered 2. draw blood culture as ordered 3. monitor hepatic and renal studies 4. prepare the child for immediate surgery

2

The nurse observes as a child with Duchenne muscular dystrophy attempts to rise from a sitting position on the floor. After attaining a kneeling position, the child "walks" his hands up his legs to stand. The nurse documents this as which sign? 1.Galeazzi's sign 2.Goodell's sign 3.Goodenough's sign 4.Gower's sign

4

The nurse should assess a child with newly diagnosed hyperthyroidism for which signs or symptoms? Select all that apply. 1. weight gain 2. dry skin 3. constipation 4. rapid pulse 5. heat intolerance

4,5

Which finding indicates that the infant has adequately evacuated the barium after undergoing a barium enema? 1.absence of fecal mass in the lower abdomen 2. stools that progress from clay-colored to brown 3. bowel sounds of 30 per minute 4. stool guaiac that is negative

2

A child with a fractured left femur receives a cast. A short time later, the nurse notices that the toes on the child's left foot are edematous. Which nursing action would be most appropriate? 1.applying ice to the foot 2.massaging the toes 3.elevating the foot of the bed 4.placing the child on his right side

3

A nurse is caring for a pediatric client with scoliosis who has to wear a brace. The nurse should develop a teaching plan with the client to include which instruction? 1.Wear the brace during waking hours. 2.Use lotions to relieve skin irritations. 3.Wear a form-fitting t-shirt under the brace. 4.Bathe the skin under the brace once per week.

3

According to Erikson's psychosocial theory of development, an 8-year-old child would be in which stage? 1.trust versus mistrust 2.initiative versus guilt 3.industry versus inferiority 4.identity versus role confusion

3

According to Erikson's theory of development, chronic illness can interfere with which stage of development in an 11-year-old child? 1.intimacy versus isolation 2.trust versus mistrust 3.industry versus inferiority 4.identity versus role confusion

3

An 8-year-old child is admitted with a T3 spinal cord compression following a motor vehicle accident. The child has an abrupt onset of elevated blood pressure, headache, profuse sweating, and flushing of the skin. What is the priority action for the nurse to take? 1.Place the child in a supine position. 2.Administer a fluid bolus. 3.Empty the child's bladder. 4.Obtain a blood glucose level.

3

The nurse provides a neonate with an initial feeding. The nurse would suspect a tracheoesophageal fistula if the neonate demonstrated which behavior? 1.sucking attempts that are too poorly coordinated to be effective 2. projectile vomiting that occurs after drinking 4 oz (120 mL) 3. coughing, choking, and cyanosis that occur after several swallows of formula 4. sleeping that occurs after taking 10 mL of formula

3

A child brought to the hospital with ketoacidosis is to receive regular insulin via an IV infusion. Which IV solution should the nurse expect the primary care provider to prescribe initially? 1.2.5% dextrose 2.5% dextrose 3.0.45% saline 4.0.9% saline

4

An 11-year-old child is diagnosed with scoliosis and scheduled for brace application. The parent asks the nurse how long her child will have to wear the brace. How should the nurse respond? 1."about 6 to 8 weeks" 2. "about 6 months" 3. "about 1 to 2 years" 4. "about 3 to 5 years"

4

The nurse is caring for a 10-year-old child who is newly diagnosed with type 1 diabetes mellitus. The nurse is teaching the parents how to recognize signs and symptoms of hyperglycemia. Which of the following is most important for the nurse to include as an initial symptom of hyperglycemia? 1. weight gain 2. increased thirst 3. paresthesia 4. decreased urine output

2

The physician suspects tracheoesophageal fistula in a 1-day-old neonate. Which nursing intervention is most appropriate for this child? 1.avoiding suctioning unless cyanosis occurs 2.elevating the neonate's head and giving nothing by mouth 3. elevating the neonate's head for 1 hour after feedings 4. giving the neonate only glucose water for the first 24 hours

2

During a developmental screening, the nurse finds that a toddler child with cerebral palsy has arrested social and language development. What should the nurse tell the family? 1. this is a sign the cerebral palsy is progressing 2. your child head reached his max language abilities 3. i need to refer you for more developmental testing 4. we need to modify your therapy plan

3

The nurse is caring for the following infant after surgery. Which short term goal is the priority? 1. The infant will continue breastfeeding 3 to 5 times daily. 2.The infant will bond with parents by holding and cuddling during each visit. 3.The infant will remain infection free in the postoperative period. 4.The infant will maintain 5 to 7 moderately wet diapers daily.

3

The nurse is planning interventions for a school-aged child hospitalized with acute poststreptococcal glomerulonephritis in need of diversional activity. Which activity should the nurse expect to include? 1.playing a card game with someone the same age 2.putting together a puzzle with mother 3.playing video games with a 4-year-old 4.watching a movie with a younger brother

1

Which assessment would be most important for the nurse to make initially in a school-age child being seen in the clinic who has a sore throat, muscle tenderness, arms feeling weak, and generally is not feeling well? 1. difficulty swallowing 2. diet intake for the last 24 hours 3. exposure to illnesses 4. difficulty urianting

1