PEDIATRIC EAQs for exam 2
What should the nurse teach the parent of an infant who is at risk for infections?
"Breast-feeding will provide protection against bacteria."
A worried parent informs the nurse, "My 6-year-old is otherwise healthy but still wets the bed at night." The nurse is teaching the parent necessary steps to manage the child's nocturnal enuresis. Which statement made by the parent indicates effective learning? Select all that apply.
"I should avoid giving my child fruit juice after 4:00 pm." "I should encourage my child to drink lots of water during the day." "I should wake my child at the same time every night to use the bathroom."
A nurse is obtaining the health history of a 7-month-old who has had repeated episodes of otitis media. What question is most important for the nurse to include in the interview with the mother?
"Please describe your child's feeding pattern."
The nurse is assessing an 8-year-old child who suffers from encopresis (impacted). Which advice given by the nurse provides effective treatment for the child? Select all that apply.
"You should drink lots of fluid." "You should include cereals in your diet." "You should eat fresh fruit for breakfast."
A nurse is obtaining a health history from the mother of a 2-month-old infant with a diagnosis of hypertrophic pyloric stenosis (HPS). What is the most significant finding about the cause of the infant's HPS?
A first cousin underwent surgery for HPS.
What assessment finding in a newborn is suggestive of cystic fibrosis?
Abdominal distention Meconium ileus
A nurse is caring for a 9-month-old infant with gluten-induced enteropathy. What common term for this disorder should the nurse use when discussing the infant's diagnosis with the parents?
Celiac disease
At the age of 3 weeks an infant undergoes surgery to repair a cleft lip. What should postoperative nursing care include?
Cleansing the suture line to prevent infection
A nurse is caring for a 4-week-old infant with hypertrophic pyloric stenosis who has been admitted to the pediatric unit for corrective surgery. What is the primary objective of preoperative care for this infant?
Correcting fluid and electrolyte imbalances
The nurse observes bleeding into the subgaleal compartment upon reviewing a child's magnetic resonance imaging (MRI) results. What other conditions should the nurse evaluate for in the child? Select all that apply.
Decreased platelet levels Decreased hematocrit levels
What common finding can the nurse identify in most children with symptomatic cardiac malformations?
Delayed physical growth
What clinical finding does a nurse expect when assessing a 4-month-old infant with gastroenteritis and moderate dehydration?
Depressed anterior fontanel
Which of the following are congenital anomalies or birth defects seen in children? Select all that apply.
Dysplasias Disruptions Deformations
A cast is applied to the involved extremity of an infant with talipes equinovarus (clubfoot). How often does the nurse tell the parents to bring their baby back to the clinic for a cast change?
Each week
A nurse is caring for an infant with a cleft lip and palate. What information should the nurse include when teaching the parents about this diagnosis?
Expectation that these children will have no other defect and otherwise will be healthy
A nurse is discussing an infant's diet with a mother who is breastfeeding. Why should the nurse recommend that the infant be offered solid foods by 5 or 6 months of age? Select all that apply.
Fetal iron reserves are depleted. Food can be taken from a spoon.
During change-of-shift report, the oncoming nurse receives information about a 14-month-old infant who underwent cleft palate repair the previous day. The child is currently on a full-liquid diet from cups only. No spoons or straws are allowed in the child's mouth. In addition, the child has elbow restraints on both arms. What care should the nurse include during the course of the shift?
Finishing each meal with a drink of water
The mother of an infant with a congenital heart defect who was admitted to the pediatric unit with heart failure asks why her baby must be weighed each morning. The nurse explains that the baby's treatment is based on changes in the daily weight. What complication can be prevented if treatment is successful?
Fluid retention
A 4-week-old infant is admitted to the pediatric unit for cleft lip repair. The nursing assistant asks the nurse why the repair is being done at this age. What is the best response the nurse can give as to why cleft lip repair is performed so soon?
Has an emotional effect on the parents
An infant with the diagnosis of exstrophy of the bladder undergoes surgery to close the defect. What must the nurse include in the discharge teaching for the parents?
How to identify signs of a urinary tract infection
During the assessment of a hospitalized infant, the nurse notes dry mucous membranes, absence of tears when the infant cries, and poor skin turgor. Which parameter will help the nurse further evaluate these findings?
Intake and output over the past 24 hours
An infant with tetralogy of Fallot becomes cyanotic and dyspneic after a crying episode. In what position should the nurse place the infant to relieve the cyanosis and dyspnea?
Knee-chest
The nurse is teaching a group of parents about the side effects of vaccines. Which side effect should the nurse include in teaching about the Haemophilus influenzae (Hib) vaccine?
Low-grade fever
A nurse is caring for an infant with phenylketonuria. What diet should the nurse anticipate will be prescribed by the healthcare provider?
Low-phenylalanine
A nurse is caring for an infant with heart failure. What treatment does the nurse most likely anticipate in the care of this infant?
Medications that are prescribed for both children and adults
A 3-month-old infant who has a 3-day history of diarrhea is admitted to the pediatric unit. The nurse obtains the infant's vital signs, performs a physical assessment, and reviews the infant's arterial blood gas results. Which acid-base imbalance does the nurse suspect? ABG- pH 7.3 PCO3 35 HCO3 17 pulse 155 resp. 40
Metabolic acidosis
An 11-month-old is admitted with dehydration and a serum sodium level of 120 mEq/L (120 mmol/L). Reporting of which assessment finding to the healthcare provider is a priority?
Muscle twitching in all extremities
What is the first action a nurse should take before administering a tube feeding to an infant?
Offering a pacifier to the infant
An infant is admitted to the hospital with gastroenteritis. The infant vomits shortly after admission. Under standard precautions, what protective equipment should the nurse wear when cleaning the infant after the vomiting episode?
Pair of gloves
An infant with a congenital heart defect is returned to the unit after cardiac catheterization. The nurse manager is observing a nurse newly assigned to the unit. Which nursing intervention should the nurse manager interrupt?
Performing range-of-motion exercises
An infant who was just returned to the pediatric unit after surgery is drowsy. What should the nurse do to maintain an airway? .
Place the child in a side-lying position. The side-lying position will allow emesis or other obstructive fluid to drain from the mouth and prevent aspiration.
A complete blood count is prescribed for a 5-month-old infant with tetralogy of Fallot. What does the nurse expect to see when reviewing the laboratory results?
Polycythemia
A 3-month-old infant with chronic constipation has a tentative diagnosis of Hirschsprung disease. What definitive diagnostic test does the nurse expect to prepare the infant for?
Rectal biopsy
A nurse inserts a nasogastric tube before an infant is to receive a tube feeding. What action should the nurse take when the infant begins to cough and gag?
Removing the tube, then reinserting it
A nurse is caring for an infant after a cleft lip repair. Which item should the nurse use to feed the infant for several days after the surgery?
Rubber-tipped syringe
An infant who has undergone surgery for hypertrophic pyloric stenosis (HPS) is being bottle fed by the mother. What should the nurse teach the mother about feedings to decrease the chance of the infant vomiting?
Start with small, frequent feedings.
The mother of an infant with hypertrophic pyloric stenosis (HPS) asks the nurse many questions about the problem. What information should the nurse convey when answering these questions?
Surgery is usually necessary.
The parent of a 10-month-old infant with otitis media tells the nurse in the pediatric clinic that this is the baby's third episode in 3 months. The infant is tugging at the ear but is not acutely ill. What factor should the nurse consider before responding?
The labyrinth and cochlea are inflamed.
A nurse is planning to assess the vomitus of an infant with pyloric stenosis. Why does the nurse anticipate that the vomitus will be white rather than bile-stained?
There is an obstruction above the opening of the common bile duct.
When explaining the occurrence of febrile seizures to a parents' class, what information should the nurse include?
They may occur in minor illnesses.
A nurse is preparing for a teaching session with the parents of an infant with phenylketonuria (PKU). The parents are upset and want an explanation of why the child has this disease that they have never heard of. What should the nurse consider before responding?
This autosomal recessive disorder was inherited from parents who are carriers. PKU is an inherited metabolic disorder
An infant has been admitted for dehydration as a result of acute gastroenteritis and vomiting, and the nurse administers lactated Ringer solution intravenously. The nurse concludes that the treatment has been effective after noting what?
Three wet diapers in 24 hours
After surgery for a myelomeningocele, an infant is being fed by means of gavage. When checking placement of the feeding tube, the nurse is unable to hear the air injected because of noisy breath sounds. What should the nurse do next?
Try aspirating stomach contents.
If a 5½-month-old infant's immunizations are on schedule, which immunizations does the nurse expect the infant to have had already?
Two doses of diphtheria, tetanus, and pertussis vaccine
A nurse provides clapping, percussion, and postural drainage every 4 hours for a 3-month-old infant with cystic fibrosis. When is the best time for the nurse to schedule chest physiotherapy?
Two hours after feedings
The parents of an infant with newly diagnosed cystic fibrosis ask a nurse what causes the foul-smelling, frothy stool. What is the best response by the nurse?
Undigested fat
The parents of an infant who has undergone surgical repair of a myelomeningocele express concern about skin care and ask what they can do to prevent problems. What should the nurse teach the parents about their infant's skin care?
Will require long-term multidisciplinary follow-up care
Which symptoms present in a child indicate Turner syndrome? Select all that apply.
a short neck with a webbed appearance low hairline at the back of the neck low-set ears hands and feet that are swollen or puffy at birth and soft nails that turn upward
A nurse is caring for an infant with severe dehydration. Which blood gas report most likely reflects the acid-base balance of this infant?
pH of 7.20 and HCO 3 - of 20 mEq/L (20 mmol/L)
