NCLEX Peds - Exam 1

When a child injures the epiphyseal plate from a fracture, the damage may result in which of the following? A. Rheumatoid arthritis B. Permanent nerve damage C. Osteomyelitis D. Bone growth disruption

D. Bone growth disruption

Nurse Elena is handling a 7-year-old child who has cystitis. Which of the following would Nurse Elena expect when assessing the child? A. Dysuria B. Costovertebral tenderness C. Flank pain D. High fever

A: Dysuria --> cystitis = inflammation of the bladder most commonly called UTI

A child with thalassemia (inherited blood disorder that causes your body to have less hemoglobin than normal) was given deferoxamine (Desferal); which of the following should alert the nurse to notify the physician? A. Decreased hearing B. Hypertension C. Red urine D. Vomiting

A. Decreased hearing --> deferoxamine is ototoxic b-hypotension should be reported c-red urine is expected d-vomiting is not an emergency for this drug

Mr. Lopez has a 7-year-old son with growth hormone (GH) deficiency. He shares to the nurse the desire of his son to play ball games. However, his wife feels the child will be in danger since he is smaller than the other children. In planning anticipatory guidance for these parents, the nurse should keep in mind which of the following? A. The child should be allowed to play because doing so can foster healthy self-esteem. B. The risk for fractures is increased because a GH deficiency results in fragile bones. C. Activity could aggravate insulin sensitivity, causing hyperglycemia. D. Activity would aggravate the child's joints, already over tasked by obesity.

A. The child should be allowed to play because doing so can foster healthy self-esteem.

Alice is rushed to the emergency department during an acute, severe prolonged asthma attack and is unresponsive to usual treatment. The condition is referred to as which of the following? A. Status asthmaticus B. Reactive airway disease C. Intrinsic asthma D. Extrinsic asthma

A: Status asthmaticus B= Reactive airway disease: another general term for asthma C= intrinsic: IgE is usually only involved locally, within the airway passages D: Extrinsic: involves external precipitating factors such as allergens (more common)

3-year-old child is receiving dextrose 5% in water and half-normal saline solution at 100 ml/hour. Which sign or symptom suggests excessive I.V. fluid intake? Worsening dyspnea Gastric distension Nausea and vomiting Temperature of 102°F (38.9° C)

A: Worsening dyspnea -->Dyspnea and other signs of respiratory distress signify fluid volume excess (overload), which can occur quickly in a child as fluid shifts rapidly between the intracellular and extracellular compartments. Gastric distention may suggest excessive oral fluid intake or infection. Nausea and vomiting or an elevated temperature may indicate a fluid volume deficit.

Mrs. Cooper is concerned about her 4-month-old son's unusual condition; which of the following statements made by her would indicate that the child may have cerebral palsy? A. "He holds his left leg so stiff that I have a hard time putting on his diapers." B. "My baby won't lift his head up and look at me; he's so floppy." C. "My baby's left hip tilts when I pull him to standing position." D. "I'm very worried because my baby has not rolled all the way over yet."

B. "My baby won't lift his head up and look at me; he's so floppy." -->hypotonia = early manifestation of cerebral palsy A- Although rigidity and tenseness are possible signs of cerebral palsy, a limitation in one leg suggests DDH. C-Tilting of the hip is an indication of developmental dysplasia of the hip (DDH). D-Rolling completely over usually does not occur until the infant is 6 months.

An infant with a patent ductus arteriosus is admitted to the pediatric unit ward. The nurse anticipates which of the following medications will be given to the infant? A. Prednisone B. Ibuprofen C. Penicillin D. Albuterol

B. ibuprofen --> when surgical ligation is not indicated, prostaglandin inhibitors are used to close the ductus

Baby Melody is a neonate who has a very-low-birth-weight. Nurse Josie carefully monitors inspiratory pressure and oxygen (O2) concentration to prevent which of the following? A. Meconium aspiration syndrome B. Bronchopulmonary dysplasia (BPD) C. Respiratory syncytial virus (RSV) D. Respiratory distress syndrome (RDS)

B: Bronchopulmnary dysplasia (BPD) --> close monitoring is necessary to prevent BPD, which is related to the use of high inspiratory pressures and O2 concentrations in especially very-low-birth-weight neonates A: meconium aspiration syndrome is created by the aspiration of meconium in the perinatal period B: RSV most commonly presents as an upper respiratory infection D: RDS is a disorder caused by lack of surfactant, usually found in premature neonates

Nurse Kathy is assessing infantile reflexes in a 9-month-old baby; which of the following would she identify as normal? A. Persistent rooting B. Bilateral parachute C. Absent moro reflex D. Unilateral grasp

B: bilateral parachute --> while holding baby, tip downwards and baby's arm should go out in front and above head to "catch" themselves

Which of the following is the most common permanent disability in childhood? A. Scoliosis B. Muscular dystrophy C. Cerebral palsy D. Developmental dysplasia of the hip (DDH)

C. Cerebral palsy --> permanent disorders affecting the development of movement and causing a limitation of activity A- scoliosis should NOT cause permanent disability B- Muscular dystrophy is a group of disorders that cause progressive degeneration and weakness of skeletal muscles. D-The long-term outcome of treated DDH is based on the degree of dysplasia, the age of diagnosis and type of treatment, and whether a concentrically reduced hip joint was obtained

Mr. and Mrs. Andrews' child was diagnosed with Duchenne's muscular dystrophy; which of the following usually is the first indication of the condition? A. Inability to suck in the newborn B. Lateness in walking in the toddler C. Difficulty running in the preschooler D. Decreasing coordination in the school-age child

C. Difficulty running in the preschooler --> usually s/sx of DMD aren't noticed until ages 3-5 and usually NOT diagnosed in the infant/toddler period

Mr. and Ms. Byers' child failed to pass meconium within the first 24 hours after birth; this may indicate which of the following? A. Celiac disease B. Intussusception C. Hirschsprung's disease D. Abdominal-wall defect

C. Hirschsprung's disease --> failure to pass meconium within the first 24hrs after birth may be a sign of hirschsprungs disease

Which of the following tests is most effective in diagnosing hemophilia? A. Bleeding time B. Complete blood count (CBC) C. Partial thromboplastin time (PTT) D. Platelet count

C. Partial thromboplastin time (PTT) --> PTT will be prolonged A-bleeding time is normal in hemophilia B-CBC is not affected by hemophilia D- platelet count is generally considered normal

Which of the following organisms is the most common cause of urinary tract infection (UTI) in children? A. Klebsiella B. Staphylococcus C. Escherichia coli D. Pseudomonas

C: Escherichia coli (E.Coli)

Molly, with suspected rheumatic fever, is admitted to the pediatric unit. When obtaining the child's history, the nurse considers which information to be most important? A. A fever that started 3 days ago B. Lack of interest in food C. A recent episode of pharyngitis D. Vomiting for 2 days

C: a recent episode of pharyngitis --> activation of the innate immune system begins with a pharyngeal infection

While Lawrence is being assessed at the clinic, Nurse Rachel observed that the child appears to be small, with an immature face and chubby body build. Her parents stated that their child's rate of growth of all body parts is somewhat slow, but her proportions and intelligence remain normal. As a knowledgeable nurse, you know that the child has a deficiency of which of the following? A. Antidiuretic hormone (ADH) B. Parathyroid hormone (PTH) C. Growth hormone (GH) D. Melanocyte-stimulating hormone (MSH)

C: growth hormone (GH) A- deficiency in ADH results in diabetes insipidus marked by dehydration and hypernatremia B- deficiency in PTH causes hypocalcemia, marked by tetany, convulsions, and muscle spasms D- deficiency in MSH causes diminished or absent skin pigmentation

Olivia is an adolescent who has seizure disorder; which of the following would not be a focus of a teaching program? A. Ability to obtain a driver's license B. Drug and alcohol abuse C. Increased risk of infections D. Peer pressure

C: increased risk of infections --> adolescents with seizure disorders are at no greater risk for infection that other adolescents

When creating a teaching program for the parents of Jessica who is diagnosed with pulmonic stenosis (PS), Nurse Alex would keep in mind that this disorder involves which of the following? A. A single vessel arising from both ventricles B. Obstruction of blood flow from the left ventricle C. Obstruction of blood flow from the right ventricle D. Return of blood to the heart without entry to the left atrium

C: obstruction of blood flow from the RIGHT ventricle --> pulmonic stenosis is a defect of the pulmonic valve in which the valve is stiffened, causing an obstruction to flow

Which of the following instructions should Nurse Cheryl include in her teaching plan for the parents of Reggie with otitis media? A. Placing the child in the supine position to bottle-feed B. Giving prescribed amoxicillin (Amoxil) on an empty stomach C. Cleaning the inside of the ear canals with cotton swabs D. Avoiding contact with people who have upper respiratory tract infections

D. Avoiding contact with people who have upper respiratory tract infections

When assessing a child's cultural background, the nurse in charge should keep in mind that: A. Heritage dictates a group's shared values B. Physical characteristics mark the child as part of a particular culture C. Cultural background usually has little bearing on a family's health practices D. Behavioral patterns are passed from one generation to the next

D. Behavioral patterns are passed from one generation to the next

A 6-year-old child is scheduled to have measles, mumps, and rubella (MMR) vaccine. Which of the following routes will you expect the nurse to administer the vaccine? A. Intramuscularly in the vastus lateralis muscle. B. Intramuscularly in the deltoid muscle. C. Subcutaneously in the gluteal area. D. Subcutaneously in the outer aspect of the upper arm.

D. Subcutaneously in the outer aspect of the upper arm. A- preferred site in small children is the anterolateral aspect of the thigh B- MMR is not administered intramuscularly C- gluteal area is not used as a site

Which of the following applies to the defect emerging from residual peritoneal fluid confined within the lower segment of the processus vaginalis? A. Inguinal hernia B. Incarcerated hernia C. Communicating hydrocele D. Noncommunicating hydrocele

D.Noncommunicating hydrocele -->With a noncommunicating hydrocele, residual peritoneal fluid is trapped within the lower segment of the processus vaginalis (the tunica vaginalis). There is no communication with the peritoneal cavity and the fluid usually is absorbed during the first months after birth. A: An inguinal hernia arises from the incomplete closure of the processus vaginalis leading to the descent of an intestinal portion. An inguinal hernia is an opening in the myofascial plain of the oblique and transversalis muscles that can allow for herniation of intra abdominal or extraperitoneal organs. B: Incarceration occurs when the hernia becomes tightly caught in the hernia sac. At times an inguinal hernia can present with severe pain or obstructive symptoms caused by incarceration or strangulation of the hernia sac contents. C: A communicating hydrocele usually is associated with an inguinal hernia because the processus vaginalis remains open from the scrotum to the abdominal cavity. The tunica vaginalis is a potential space for fluid to accumulate, provided the proximal portion of processus vaginalis remains patent and results in free communication with the peritoneal cavity, leading to congenital hydrocele.

A 5-year-old girl Hannah is recently diagnosed with Kawasaki disease. Apart from the identified symptoms of the disease, she may also likely develop which of the following? A. Sepsis B. Meningitis C. Mitral valve disease D. Aneurysm formation

D: Aneurysm formation -->kawasaki affects the blood vessels

Steve is diagnosed with celiac disease and experiences celiac crisis secondary to upper respiratory tract infection; which of the following would Nurse Nancy expect to assess? A. Lethargy B. Weight gain C. Respiratory distress D. Watery diarrhea

D: Watery diarrhea --> celiac crisis is typically characterized by severe watery diarrhea C: respiratory distress is unlikely in a routine upper respiratory tract infection

It is considered as the bluntly rounded portion of the heart. A. Base B. Pericardium C. Aorta D. Apex

D: apex

A female child, age 6, is brought to the health clinic for a routine checkup. To assess the child's vision, the nurse should ask: A. "Do you have any problems seeing different colors?" B. "Do you have trouble seeing at night?" C. "Do you have problems with glare?" D. "How are you doing in school?"

D: how are you doing in school --> all other options are appropriate when assessing the geriatric population

Which of the following disorders leads to cyanosis from deoxygenated blood entering the systemic arterial circulation? A. Aortic stenosis (AS) B. Coarctation of aorta C. Patent ductus arteriosus (PDA) D. Tetralogy of Fallot

D: tetralogy of fallot

The nurse is aware that the most common assessment finding in a child with ulcerative colitis is: A. Intense abdominal cramps B. Profuse diarrhea C. Anal fissures D. Abdominal distention

B: profused diarrhea --> main symptoms of ulcerative colitis include bloody diarrhea, with or without mucus abdominal distention is more associated with crohn's disease!

In growing children, growth hormone deficiency results in short stature and very slow growth rates. Short stature may result from which of the following? A. Anterior pituitary gland hypofunction B. Posterior pituitary gland hyperfunction C. Parathyroid gland hyperfunction D. Thyroid gland hyperfunction

A: anterior pituitary gland hypofunction --> short stature usually results from diminished growth hormone, which is released from the anterior pituitary gland B: posterior pituitary hyperfunction results in increased secrtion of ADH or oxytocin C: parathyroid hypofunction leads to hypocalcemia D: thyroid hyperfunction causes increased secretion of thyroxine, triodothyronine, and thyrocalcitoinin (graves disease)

Beta-adrenergic agonists such as albuterol are given to Reggie. a child with asthma. Such drugs are administered primarily to do which of the following? Dilate the bronchioles Reduce secondary infections Decrease postnasal drip Reduce airway inflammation

A: dilate the bronchioles --> albuterol = bronchodilators!!

A child is undergoing remission induction therapy to treat leukemia. Allopurinol is included in the regimen. The main reason for administering allopurinol as part of the client's chemotherapy regimen is to: Prevent metabolic breakdown of xanthine to uric acid Prevent uric acid from precipitating in the ureters Enhance the production of uric acid to ensure adequate excretion of urine Ensure that the chemotherapy doesn't adversely affect the bone marrow

A: prevent metabolic breakdown of xanthine to uric acid

Betty is a 9-year-old girl diagnosed with cystic fibrosis. Which of the following must Nurse Archie keep in mind when developing a care plan for the child? A. Pulmonary secretions are abnormally thick. B. Elevated levels of potassium are found in sweat. C. CF is an autosomal dominant hereditary disorder. D. Obstruction of the endocrine glands occurs.

A: pulmonary secretions are abnormally thick

A child with Kawasaki disease is admitted to the pediatric ward. Which of the following medications will you expect to be a part of the treatment? Select all that apply. A. Gamma Globulin B. Warfarin. C. Acetaminophen D. Aspirin E. Atenolol

Answer: A, B, D

Scott is a teenager suffering from osteomyelitis; the nurse would expect which of the following symptoms? Select all that apply. A. Fever B. Irritability C. Pallor D. Tenderness E. Swelling

Answer: A,B,D,E

Which of the following should be included when developing a teaching plan to prevent urinary tract infection? Select all that apply. A. Maintaining adequate fluid intake B. Avoiding urination before and after intercourse C. Emptying bladder with urination D. Wearing underwear made of synthetic material such as nylon E. Keeping urine alkaline by avoiding acidic beverages F. Avoiding bubble baths and tight clothing

Answer: A,C,F

In pediatric gastroesophageal reflux disease (GERD), the immaturity of lower esophageal sphincter function is manifested by frequent transient lower esophageal relaxations, which result in retrograde flow of gastric contents into the esophagus. Which statement about the esophagus is true? Select all that apply. A. It is a cartilaginous tube. B. It has upper and lower sphincters. C. It lies anterior to the trachea. D. It extends from the nasal cavity to the stomach. E. It is a highway for food and drinks to travel along to make it to the stomach. F. All statements describe the esophagus.

Answer: B & E A: esophagus is a MUSCULAR tube C: esophagus lies anterior to the VERTEBRAE and posterior to the TRACHEA D: esophagus extends from the pharynx to the stomach

The 6-year-old son of Mr. and Mrs. Peters is admitted to the healthcare facility with the diagnosis of idiopathic hypopituitarism. His height is measured below the third percentile and weight at the 40th percentile. Which of the following would be the first action of his attending nurse? A. Recommend orthodontic referral for underdeveloped jaw. B. Collaborate with a dietician to access his caloric needs. C. Provide for a tutor for his precocious intellectual ability. D. Place him in a room with a 2-year-old boy.

B: collaborate with a dietician to access his caloric needs --> bc the child's weight is excessive for his height, he needs a dietary assessment and weight loss program

Nurse Jeremy is evaluating a client's fluid intake and output record. Fluid intake and urine output should relate in which way? A. Fluid intake should double the urine output. B. Fluid intake should be approximately equal to the urine output. C. Fluid intake should be half the urine output. D. Fluid intake should be inversely proportional to the urine output.

B: fluid intake should be approximately equal to the urine output A- may indicate fluid retention (edema or hepatomegaly) B- fluid intake half the urine output may indicated dehydration D- not inverse relationship

When educating parents regarding known antecedent infections in acute glomerulonephritis, which of the following should the nurse cover? A. Scabies B. Impetigo C. Herpes simplex D. Varicella

B: impetigo --> impetigo, a bacterial infection of the skin, may be caused by streptococci and may precede to acute glomerulonephritis

A child diagnosed with intellectual disability (ID) is under the supervision of Nurse Tasha. The nurse is aware that the signs and symptoms of mild ID include which of the following? A. Few communication skills B. Lateness in walking C. Mental age of a toddler D. Noticeable developmental delays

B: lateness in walking --> delay in achieving developmental milestones, such as walking

Dustin who was diagnosed with Hirschsprung's disease has a fever and watery explosive diarrhea. Which of the following would Nurse Joyce do first? A. Administer an antidiarrheal. B. Notify the physician immediately. C. Monitor the child every 30 minutes. D. Nothing. (These findings are common in Hirschsprung's disease.)

B: notify the physician immediately --> Hirschsprung's disease is a condition that affects the large intesting and causes problems with passing stool. for the child with hirschsprung's disease, fever and explosive diarrhea indicate entercolitis (a life threatening situation)

When developing a plan of care for a hospitalized child, nurse Mary knows that children in which age group is most likely to view illness as a punishment for misdeeds? A. Infancy B. Preschool age C. School age D. Adolescence

B: preschool age

Fred is a 12-year-old boy diagnosed with pneumococcal pneumonia. Which of the following would Nurse Nica expect to assess? Mild cough Slight fever Chest pain Bulging fontanel

C: chest pain mild cough and slight fever = viral pneumonia

After explaining to the parents about their child's unique psychological needs related to a seizure disorder and possible stressors, which of the following interests uttered by them would indicate further teaching? A. Feeling different from peers B. Poor self-image C. Cognitive delays D. Dependency

C: cognitive delays --> children with seizure disorders do not necessarily have cognitive delays

the American Association on Mental Deficiency (AAMD), now American Association on Intellectual and Developmental Disabilities (AAIDD) definition of mental retardation emphasizes which of the following? A. An IQ level that must be below 50 B. Cognitive impairment occurring after age 22 years C. Deficits in adaptive behavior with intellectual impairment D. No responsiveness to contact

C: deficits in adaptive behavior with intellectual impairment A- IQ of 70 or below is considered significantly subaverage intellectual functioning

Which of the following would Nurse Tony suppose to regard as a cardinal manifestation or symptom of digoxin toxicity to his patient Clay diagnosed with heart failure? A. Headache B. Respiratory distress C. Extreme bradycardia D. Constipation

C: extreme bradycardia --> extreme bradycardia is a cardinal sign of digoxin toxicity. increased intracellular calcium from the poisoning of the Na-K transporter and AV nodal blockage from increased vagal tone are the primary causes of dig tox

A child newly diagnosed with diabetes mellitus has been stabilized with insulin injections daily. A nurse prepares a discharge teaching plan regarding the insulin. The teaching plan should reinforce which of the following concepts? A. Always keep insulin vials refrigerated B. Increase the amount of insulin before exercise C. Ketones in the urine signify a need for less insulin D. Systematically rotate injection sites

D. Systematically rotate injection sites

Hannah, age 12, is 7 months pregnant. When teaching parenting skills to an adolescent, the nurse knows that which teaching strategy is least effective? A. Providing a one-on-one demonstration and requesting a return demonstration, using a live infant model B. Initiating a teenage parent support group with first and second-time mothers C. Using audiovisual aids that show discussions of feelings and skills D. Providing age-appropriate reading materials

D: providing age-appropriate reading materials -->adolescents absorb less information through reading!