Nursing 153 Pediatrics Final Review

The nurse is teaching the parents of a child who is receiving methimazole (Tapazole) for the treatment of hyerthyroidism (Graves disease). Which statement made by the parent indicates understanding?

"If my child develops a sore throat and fever, I should contact the physician immediately."

The nurse is teaching the parent about the diet of a child experiencing severe edema associated with acute glomerulonephritis. Which information should the nurse include in the teaching?

"You will need to avoid adding salt to your child's food."

A child has an NG tube to continuous low intermittent suction. The physician's prescription is to replace the previous 4 hour NG output with normal saline piggyback over a 2 hour period. The NG output for the previous 4 hours totaled 50 ml. What ml/hr ate should the nurse administer to replace normal saline piggyback?

25ml/hr

Which term is used to describe a type of fracture that does not break skin?

Simple

A clinic nurse is conducting a staff in-service for other clinic nurses about signs and symptoms of rhabdomyosarcoma tumor. Which should be included in the teaching session?

Sore throat and ear pain Ecchymosis of conjunctiva Abdominal mass

When caring for a child with probable appendicitis, the nurse should alert to recognize that which condition or symptom is a sign of perforation?

Sudden relief from pain

Which therapeutic management treatment is implemented for children with Hirschsprung disease?

Surgical removal of affected section of bowel

The nurse is admitting a newborn with hypospadias to the nursery. The nurse expects which finding in this newborn?

The urethral opening is along the ventral surface of the penis

The nurse is caring for a 5-year-old child with impetigo contagiosa. The parents ask the nurse what will happen to their child's skin after the infection has subsided and healed. Which answer should the nurse give?

There will be no scarring

A 4-month-old infant has gastroesophageal reflux (GER) but is thriving without other complications. What should the nurse suggest to minimize reflux?

Thicken formula with rice cereal

The nurse is taking care of an adolescent with osteosarcoma. The parents as the nurse about treatment. The nurse should make which accurate response about treatment for osteosarcoma?

Treatment usually consists of surgery and chemotherapy

The nurse is caring for an infant with developmental dysplasia of the hip. Which clinical manifestations should the nurse expect to observe?

Unequal gluteal folds Positive Ortolani click

A nurse is conducting an in-service on gastrointestinal disorders. The nurse includes that melena, the passage of black, tarry stools, suggests bleeding from which area?

Upper gastrointestinal tract

A mother asks the nurse what would be the first indication that acute glomerulonephritis is improving. What is the nurse's best response?

Urinary output will increase

When taking the history of a child hospitalized with Reye syndrome, the nurse should not be surprised that a week ago the child had recovered from which of the following?

Varicella

Which immunization should be given with caution to children infected with human immunodeficiency virus?

Varicella

The nurse should monitor for which effect on the cardiovascular system when a child is immobilized?

Venous stasis

The nurse is preparing to admit a newborn with myelomeningocele to the neonatal intensive care nursery. Which describes this newborn's defect?

Visible defect with an external saclike protrustion containing meninges, spinal fluid and nerves

Children taking phenobarbital and/or phenytoin (Dilantin) may experience a deficiency of:

Vitamin D and folic acid

The nurse is caring for an infant with a suspected urinary tract infection. Which clinical manifestations should be expected?

Vomiting Failure to gain weight Persistent diaper rash

Which assessment findings should the nurse note in a school-age child with Duchenne muscular dystrophy?

Waddling gait Gower sign Lordosis

The nurse is teaching a group of adolescents about care for acne vulgaris. The nurse should include:

Wash skin with mild soap and water twice a day Avoid sun exposure if on tetracycline Avoid picking or squeezing the lesions

Which should the nurse recommend to prevent urinary tract infections in young girls?

Wear cotton underpants

Which of the following is the most common clinical manifestation of retinoblastoma?

White eye reflex

The most common clinical manifestation of brain tumor in children are:

headaches and vomiting

A young child is brought to the emergency department with severe dehydration secondary to acute diarrhea and vomiting. Therapeutic management of this child should begin with:

intravenous fluids

A school-aged child with diarrhea has been rehydrated. The nurse is discussing the child's diet with the family. Which statement indicates a correct understanding of the teaching?

I should have my child eat a normal diet with easily digested foods for the next 48 hours.

A child is admitted with extensive burns. The nurse notes that there are burns on the child's lips and singed nasal hairs. The nurse should suspect that the child has:

Inhalation injury

Invagination of one segment of bowel within another is called which of the following?

Intussusception

Which type of dehydration is defined as "dehydration that occurs in conditions in which electrolyte and water deficits are present in approximately balanced proportion"?

Isotonic dehydration

The nurse is planning care for an 8 year old child with a concussion. Which is descriptive of a concussion?

It is transient and reversible neuronal dysfunction

The nurse is planning care for an 8-year-old child with a concussion. Which is descriptive of concussion?

It is transient and reversible neuronal dysfunction

An infant with hydrocephalus is hospitalized for surgical placement of a ventriculoperitoneal shunt. Which interventions should be included in the child's postoperative care?

Maintain an accurate record of intake and output Monitor for abdominal distention Observe closely for signs of infection

An infant with pyloric stenosis experiences excessive vomiting that can results in:

Metabolic alkalosis

An appropriate nursing intervention when caring for an unconscious child should be to:

Monitor fluid intake and output carefully to avoid fluid overload and cerebral edema

Which medication is usually tried when a child is diagnosed with juvenile idiopathic arthritis?

NAIDs (naproxen, ibuprofen, tolmetin)

An adolescent girl asks the school nurse for advice because she has dysmenorrhea. She says that friend recommended she try an over-the-counter nonsteroidal anti-inflammatory drug. The nurse's best response should be based on which statement.

NSAIDs are effective because they inhibit prostaglandins, leading to reduction in uterine activity

A nurse is planning care for school-age child with Type 1 diabetes. Which insulin preparations are rapid and short acting?

Novolin R NovoLog

A parent has asked the nurse how her child can be tested for pinworms. The nurse responds by stating that which is the most common test for diagnosing pinworms in a child?

Observation for presence of worms after child defecates

Which best describes acute glomerulonephritis?

Occurs after streptococcal infection

Which therapeutic management should the nurse prepare to initiate first for a child with acute diarrhea and moderate dehydration?

Oral rehydration solution ORS

Which is an important consideration when the nurse is discussing enuresis with the parents of a young child?

Organic causes that may be related to enuresis should be considered first

Which observation made of the exposed abdomen is most indicative of pyloric stenosis?

Palpable olive-like mass

The nurse is caring for a child with severe head trauma after a car accident. Which is an ominous sign that often precedes death?

Periodic and irregular breathing

Type 1 diabetes mellitus is suspected in an adolescent. Which clinical manifestation may be present?

Poor wound healing

A school nurse is conducting a staff in-service to other school nurses on idiopathic scoliosis. During which period of child development does idiopathic scoliosis become most noticeable?

Preadolescent growth spurt

A hospitalized child with minimal change nephrotic syndrome is receiving high doses of prednisone. Which is an appropriate nursing goal related to this?

Prevent infection

Caring for the newborn with a cleft lip and palate before surgical repair includes:

Providing satisfaction of suckling needs

The nurse is assisting the family of a child with a history of encopresis. Which should be included in the nurse's discussion with this family?

Reassure the family that most problems are resolved successfully, with some relapses during periods of stress

Which is an important consideration in the care of a child with celiac disease?

Refer to a nutritionist for detailed dietary instructions and education

An adolescent girl is cooking on a gas stove when her bathrobe catches fire. Her father smothers the flames with a rug and calls an ambulance. She has sustained major burns over much of her body. Which is important in her immediate care?

Remove her burned clothing and jewelry

During the first few days after surgery for cleft lip, which intervention should the nurse do?

Remove restraints periodically to cuddle infant

A child with hypopituitarism is being started on growth hormone (GH) therapy. Nursing considerations should be based on knowledge of which of the following?

Replacement therapy requires daily subcutaneous injections

The nurse is teaching a family how to care for their infant in a Pavlik harness to treat developmental dysplasia of the hip. Which should be included?

Return to clinic every 1 to 2 weeks

Which pathogen is the viral pathogen that frequently causes acute diarrhea in young children?

Rotavirus

The nurse is admitting a child with Wilm's tumor. Which is the initial assessment finding associated with this tumor?

Abdominal swelling

Which of the following types of seizures may be difficult to detect?

Absence

Which is caused by a virus that primarily infects a specific subset of T lymphocytes, the CD4+ T cells?

Acquired immunodeficiency syndrome

A school aged child with leukemia experienced severe nausea and vomiting when receiving chemotherapy for the first time. Which is the most appropriate nursing action to prevent or minimize these reactions with subsequent treatments?

Administer an antiemetic before chemotherapy

The nurse is preparing to care for an infant returning from a pyloromyotomy surgery. Which prescribed orders should the nurse anticipate implementing?

Administration of analgesics for pain Clear liquids as the first feeding IV fluids continued until tolerating PO

The nurse is caring for an adolescent who has just started dialysis. The child seems always angry, hostile or depressed. To what are these behaviors most likely related?

Adolescents often resenting the control and enforced dependence imposed by dialysis

Which is characteristic of the immune-mediated type 1 diabetes mellitus?

Age at onset is usually younger than 20 years

The nurse is caring for an adolescent with osteosarcoma being admitted to undergo chemotherapy. The adolescent has right above-the-knee amputation 2 months ago and has been experiencing "phantom limb pain." Which prescribed medication is appropriate to administer?

Amitriptyline (Elavil)

Parents call the clinic and report that their toddler has had acute diarrhea for 24 hours. The nurse should further ask the parents if the toddler has which associated factor that is causing the acute diarrhea?

Antibiotic therapy

When should children with cognitive impairment for stimulation and educational programs?

As young as possible

Exophthalmos (protruding eyeballs) may occur in children with:

Hyperthyroidism

The nurse is implementing care for a school-age child admitted to the PICU in DKA. Which intervention should the nurse implement first?

Begin 0.9% saline solution intravenously as prescribed

A boy with leukemia screams whenever he needs to be turned or moved. Which is the most probably cause of his pain?

Bone involvement

Which clinical manifestations would suggest hydrocephalus in a neonate?

Bulging fontanel and dilated scalp veins

A child with leukemia is receiving intrathecal chemotherapy consisting of methotrexate, cytarbine and hydrocortisone. The purpose of this is to prevent:

Central nervous system disease

When caring for a newborn with Down syndrome, what should the nurse be aware is the most common congenital anomaly associated with Down syndrome?

Congenital heart disease

Which is instituted for the therapeutic management of minimal change nephrotic syndrome?

Corticosteriods

The nurse is caring for an infant with myelomeningocele scheduled for surgical closure in the morning. Which intervention should the nurse plan for the care of the myelomeningocele sac?

Covered with a sterile, moist, non adherent dressing

A nurse is admitting an infant with dehydration caused from water loss in excess of electrolyte loss. Which type of dehydration is this infant experiencing?

Hypertonic

Myelosuppression, associated with chemotherapeutic agents or some malignancies such as leukemia, can cause bleeding tendencies because of:

Decrease in blood platelets

An important nursing intervention when caring for a child who is experiencing a seizure would be to?

Describe and record the seizure activity of observed

A nasal spray of desmopressin acetate (DDAVP) is used to treat:

Diabetes insipidus

The nurse is teaching nursing students about childhood nervous system tumors. Which best describes a neuroblastoma?

Diagnosis is usually made after metastasis occurs

A newborn assessment show separated sagittal suture, oblique palpebral fissues, depressed nasal bridge, protruding tongue, and transverse palmar creases. Of what are these findings most suggestive?

Down syndrome

The nurse is conducting a staff-in service casts. Which is an advantage to using a fiberglass cast instead of a plaster of Paris cast?

Dries rapidly

The nurse is admitting a toddler with the diagnosis of juvenile hypothyroidism. Which is a common clinical manifestation of this disorder?

Dry skin

A nurse is caring for a neonate with suspected tracheoesophageal fistula. What nursing care should be included?

Elevate the head but give nothing by mouth

Which is the priority nursing intervention for an unconscious child after a fall?

Establish adequate aiway

A school-age child has been admitted to the hospital with an exacerbation of nephrotic syndrome. Which clinical manifestations should the nurse expect to assess?

Facial edema Fatigue Frothy-appearing urine

A nurse is conducting a staff in-service on childhood cancers. Which is the primary site of osteosarcoma?

Femur

The nurse is conducting an assessment on a school-age child with urosepsis. Which assessment finding should the nurse expect?

Fever with positive blood culture

Which condition in a child should alert a nurse for increased fluid requirements?

Fever, headache, and low red blood cell count

The nurse is planning a staff in-service on childhood spastic cerebral palsy. Spastic cerebral palsy is characterized by:

Hypertonicity and poor control of posture, balance and coordinated motion