Pediatrics Exam #2
to help alleviate the discomfort and fever of acute otitis media, the parents are advised to administer, what? select all that apply: a. acetaminophen or ibuprofen b. antihistamines c. benzocaine ear drops d. decongestants
a. acetaminophen or ibuprofen c. benzocaine ear drops
the parent of a teen with dx of Hodgkin disease asks what the child's prognosis will be with tx. what info should the nurse give to parent and child? a. clinical staging of Hodgkin dx will determine the tx; longterm survival for all stages of Hodgkin dx is excellent b. there is a considerably better prognosis if the client is diagnosed early and is between ages 5-11 c. the prognosis for Hodgkin dx depends on the type of chemo d. the only way to obtain a good prognosis is by chemotherapy and bone marrow transplant
a. clinical staging of Hodgkin dx will determine the tx; longterm survival for all stages of Hodgkin dx is excellent
school-age children with cancer often have a body image disturbance r/t hair loss, moon face or debilitation. which of the following interventions is most appropriate? a. encourage them to wear a wig similar to their own hairstyle b. emphasize the benefits of the therapy they're receiving c. have them play only with other children with cancer d. use diversional techniques to avoid discussing changes in the body because of chemo
a. encourage them to wear a wig similar to their own hairstyle
which of the following measures should the nurse implement to help with N/V from chemotherapy. select all that apply: a. give an antiemetic 30 min prior to the start of therapy b. continue the antiemetic as ordered until 24 h after the chemo is complete c. remove food that has a lot of order d. keep the child on NPO status e. wait until the nausea begins to start the antiemetic
a. give an antiemetic 30 min prior to the start of therapy b. continue the antiemetic as ordered until 24 h after the chemo is complete c. remove food that has a lot of order
in the child who is suspected of having epiglottitis the nurse should: a. have intubation equipment available b. prepare to immunize the child for H. influenzae c. obtain a throat culture d. all of the above
a. have intubation equipment available
a child dx with leukemia is receiving allopurinol as part of tx plan. the parents ask why their child is receiving this med. what info about the med should the nurse provide? a. helps reduce the uric acid level caused by cell destruction b. used to make the chemo work better c. given to reduce the N/V associated with chemo d. helps decrease pain in bone marrow
a. helps reduce the uric acid level caused by cell destruction
which of the following can be manifestations of leukemia in a child. select all that apply: a. leg pain b. fever c. excessive weight gain d. bruising e. enlarged lymph nodes
a. leg pain b. fever d. bruising e. enlarged lymph nodes
The infant is predisposed to developing otitis media because the Eustachian tubes: a. lie in a relatively horizontal plane b. have a limited amount of lymphoid tissue c. are long and narrow d. are underdeveloped
a. lie in a relatively horizontal plane
which of the following best describes the action of chemotherapeutic agents used in the tx of cancer with children? a. suppress the function of normal lymphocytes in the immune system b. are alkylating agents and are cell-specific c. cause a replication of DNA and are cell-specific d. interrupt cell cycle thereby causing cell death
a. suppress the function of normal lymphocytes in the immune system
a nurse is caring for a 15 y/o who has just been diagnosed with non-Hodgkins lymphoma. which of the following should the nurse include in teaching the parents about this lymphoma? select all that apply: a. the malignancy originates in the lymphoid system b. the presence of Reed-Sternberg cells in the biopsy is considered diagnostic c. mediastinal involvement is typical d. the disease is diffuse rather than nodular e. treatment includes chemo and radiation
a. the malignancy originates in the lymphoid system c. mediastinal involvement is typical d. the disease is diffuse rather than nodular e. treatment includes chemo and radiation
which should the nurse administer to provide quick relief to a child with asthma who is coughing, wheezing and having difficulty catching her breath? a. prednisone b. singulair (motelukast) c. albuterol d. flovent (fluticasone)
albuterol
the nurse is caring for a child with leukemia. the nurse should be aware that children being treated for leukemia may experience which of the following complications. Select all that apply: a. anemia b. infection c. bleeding tendencies d. bone deformities e. polycythemia
anemia infection
the best technique to use to prevent spread of nasopharyngitis is: a. antibiotic administration b. avoid contact with infected persons c. mist vaporization d. ensure adequate fluid intake
b. avoid contact with infected persons
which of the following is the best method to prevent the spread of infection to an immunosuppressed child? a. administer antibiotics prophylactically to the child b. have people wash their hands prior to contact with the child c. assign the same nurses to care for the child each day d. limit visitors to family members only
b. have people wash their hands prior to contact with the child
which of the following is administered prophylactically to infants at high risk for the development of RSV? a. ribavirin b. palivizumab c. pneumococcal vaccine d. penicillin G
b. palivizumab
for an older child who can tolerate decongestants and who is having difficulty breathing through his stuffy nose, the nurse should recommend: a. dextromethorphan nose drops b. phenylephrine nose drops c. dextromethorphan cough squares d. steroid nose drops
b. phenylephrine nose drops
the primary therapeutic regimen for croup usually includes a. vigilant assessment, cool mist, nebulized epinephrine and corticosteroids b. vigilant assessment, cool mist, racemic epinephrine, antibiotics c. intubation, cool mist, racemic epinephrine, corticosteroids d. intubation, nebulized epinephrine, antibiotics
b. vigilant assessment, cool mist, racemic epinephrine, antibiotics
the largest percentage of respiratory tract infections in children is caused by: a. pneumococci b. viruses c. streptococci d. haemophilus influenzae
b. viruses
which breathing exercises should the nurse have an asthmatic 3-yr-old child do to increase her expiratory phase? a. use incentive spirometer b. breathe into a paper bag c. blow a pinwheel d. take several deep breaths
blow a pinwheel
When giving tips for how to increase humidity in the home of a child with a respiratory tract infection, the nurse should emphasize that the primary concern is to ensure that the child has: a) A steam vaporizer b) A warm humidification source c) A safe humidification source d) A cool humidification source
c) A safe humidification source
a 5 y/o is admitted to the hospital with complaints of leg pain and fever. on physical exam the child is pale and has bruising over body. the HCP suspects the child has ALL. the nurse informs the parent that the dx will be confirmed by which? a. lumbar puncture b. WBC count c. bone marrow aspirate d. bone scan
c. bone marrow aspirate
most children with croup: a. require hospitalization b. will need to be intubated c. can be cared for at home d. are over age 6
c. can be cared for at home
the nurse is caring for a child who is receiving extensive radiation as part of the tx for Hodgkin disease. which intervention should be implemented? a. administer pain med prior to going to radiation tx b. assess the child for neuropathy since this is a common side effect c. provide adequate rest, as the child may experience excessive malaise and lack of energy d. encourage the child to eat a low-protein diet while on radiation tx
c. provide adequate rest, as the child may experience excessive malaise and lack of energy
of the following croup syndromes, the one that is potentially life threatening is a. spasmodic croup b. laryngotracheobronchitis c. acute spasmodic laryngitis d. acute epiglottitis
d. acute epiglottitis
in addition to acute pain, the clinical manifestations of otitis media include: a. purulent discharge in the external auditory canal b. clear discharge in the external auditory canal c. enlarged axillary lymph nodes d. enlarged cervical lymph nodes
d. enlarged cervical lymph nodes
which is the nurse's best response to a parent who asks what can be done at home to help a child with URI symptoms and a fever get betteR? a. give child small amount of fluid qh to prevent dehydration b. give child robitussin at night to reduce cough and help him sleep c. give child baby aspirin q4-6h to help reduce fever d. give your child an OTC cold medicine at night
give child small amount of fluid qh to prevent dehydration
an infant not sleeping well, crying frequently, has yellow drainage from the ear and is diagnosed with an ear infection. which nursing objective is the priority for the family? a. educating the parents about s/sx of ear infection b. providing emotional support for the parents c. providing pain relief for the child d. promoting the flow of drainage from the ear
providing pain relief for the child
what is the most important piece of information that the nurse must ask the parent of a child in status asthmaticus? a. what time did your child last eat? b. has your child been exposed to any of the usual asthma triggers? c. when was your child last admitted to the hospital for asthma? d. when was your child's last dose of medication?
when was your child's last dose of medication?
which laboratory result will provide the most important information regarding the respiratory status of a child with an acute asthma exacerbation? a. CBC b. ABG c. BUN d. PTT
ABG
an otoscope exam in a child with otitis media would reveal: a. bulging tympanic membrane b. a light reflex c. orange tympanic membrane d. mobile tympanic membrane
a. bulging tympanic membrane
diagnostic eval of dehydration to initiate a therapeutic plan includes. select all that apply a. serum electrolytes b. acid-base imbalance determination c. physical assessment to determine degree of dehydration d. type of dehydration based on pathophysiology
all
What is the most common cause of death due to Hirschsprung's Disease? a) Peritonitis b) Enterocolitis c) GERD d) Severe dehydration e) Hyperkalemia
b) Enterocolitis
of the following assessment findings, the one that would most likely be seen in a child with leukemia is: a. weakness of the eye muscle b. bruising, nosebleeds, pallor, fatigue c. wheezing, SOB d. abdominal swelling
b. bruising, nosebleeds, pallor, fatigue
in infants and young children, the most accurate means of describing dehydration or fluid loss is: a. as a percentage b. by millimeters per kg of body weight c. by the amount of edema present/absent d. by the degree of skin elasticity
b. by millimeters per kg of body weight
a child has completed tx for leukemia and comes to the clinic with parents for checkup. the parents express to the nurse that they are glad their child has been cured of cancer and is safe from getting cancer later in life. which of the following should the nurse consider responding? a. childhood cancer usually instills immunity to all other cancers b. children surviving one cancer are at higher risk for a second cancer c. the child may have a remission of the leukemia but is immune to all other cancers d. as long as the child continues to take steroids, there will be no other cancers
b. children surviving one cancer are at higher risk for a second cancer
children with tympanostomy tubes should a. swim only in fresh water lakes without earplugs b. keep bath water out of the ear c. notify the HCP if a grommet appears d. never allow any water to enter their ears
b. keep bath water out of the ear
a major benefit of using umbilical cord blood for stem cell transplantation is a. stem cells are found in low frequency in newborns b. umbilical cord blood is relatively immunodeficient c. there is a lower risk for acute tumor lysis syndrome d. umbilical cord blood has a greater number of neutrophils
b. umbilical cord blood is relatively immunodeficient
Which surgical intervention is sometimes used to treat Gastroesophageal Reflux? a) Sandifer's Procedure b) Enterocolostomy c) Nissen Fundoplication d) Tonsilectomy
c) Nissen Fundoplication
a 10 y/o has received chemo to which he had an anaphylactic reaction a month ago. this time how long should the nurse stay to observe the child for a reaction? a. 20 min b. 30 min c. 60 min d. 90 min
c. 60 min
a particular area of concern for the adolescent receiving radiation is a. frequent vomiting b. altered sexual function c. high risk for sterility d. precocious puberty
c. high risk for sterility
which intervention is most appropriate to teach the mother of a child diagnosed with a URI and a dry hacking cough that prevents him from sleeping? a. give cough suppressants at night b. give an expectorant every 4 hours c. give cold and flu meds every 8 hours d. give half teaspoon honey 4-5x/day
give half teaspoon honey 4-5x/day
a 5 yr old is brought to the ER with a temp of 95.5 F, barky cough, stridor, hoarseness. which nursing intervention should the nurse prepare for? a. immediate IV placement b. respiratory treatment of racemic epinephrine c. tracheostomy set at the bedside d. informing the child's parents about tonsillectomy
respiratory treatment of racemic epinephrine
which would be an early sign of respiratory distress in a 2-month-old? a. breathing shallowly b. tachypnea c. tachycardia d. bradycardia
tachypnea
the nurse is caring for an 8 wk old male who has just been diagnosed with Hirschprung disease. The parents ask what they should expect. Select the nurse's best response. a. "it is really an easy disease to manage. most children are placed on stool softeners to help with constipation until it resolves." b. " a permanent stool diversion, called a colostomy, will be placed by the surgeon to bypass the narrowed area." c. "daily bowel irrigations will help your child maintain regular bowel habits." d. "although your child will require surgery, there are different ways to manage the disease, depending on how much bowel is involved."
"although your child will require surgery, there are different ways to manage the disease, depending on how much bowel is involved."
the parent of a child with flu asks the nurse when the child is most infectious. which is the nurse's best response? a. 24 hrs before and after onset of symptoms b. 24 hrs after onset of symptoms c. 1 week after onset of symptoms d. 1 week before onset of symptoms
24 hrs before and after onset of symptoms
the nurse is caring for a 4-mo. old with gastroesophageal reflux (GER). the infant is due to receive Zantac (rantasine). based on the mechanism of action, when should the med be administered? a. immediately before feeding b. 30 min after feeding c. 30 min before feeding d. at bedtime
30 min before feeding
which statement by the parent of a child using an albuterol inhaler leads the nurse to believe that further education is needed on how to administer the medication? a. I should administer two quick puffs of the albuterol inhaler using a spacer b. i should always use a spacer when administering the albuterol inhaler c. I should be sure that my child is in an upright position when administering the inhaler d. I should always shake the inhaler before administering the dose
I should administer two quick puffs of the albuterol inhaler using a spacer
which statement indicates the parent needs further teaching on how to prevent his other children form contracting RSV? a. I should make sure that both of my children receive Synagis injections for the remainder of the year b. i should be sure to keep my infected child away from his brother until he is recovered c. I should insist that all people who come in contact with my children thoroughly wash their hands before playing with them d. I should insist that anyone with a respiratory illness avoid contact with my children until well
I should make sure that both of my children receive Synagis injections for the remainder of the year
which child with asthma should the nurse see first? a. a 12-mo-old who has a mild cry, pale in color, diminished breath sounds, O2 sat 93% b. a 5-yr-old speaking in complete sentences, pink in color, wheezing bilaterally, O2 sat of 93% c. a 9-yr-old who is quiet, pale, wheezing bilaterally with O2 sat 92% d. 16-yr-old speaking in short sentences, wheezing, sitting upright, O2 sat of 93%
a 12-mo-old who has a mild cry, pale in color, diminished breath sounds, O2 sat 93%
which child is highest risk for requiring hospitalization to treat RSV? a. a 2 mo old born at 32 weeks b. a 16 mo old with a tracheostomy c. a 3 yr old with congenital heart defect d .a 4 yr old born at 30 weeks
a 2 mo old born at 32 weeks
which child would benefit most from having ear tubes placed? a. a 2 mo old who had one ear infection b. a 2 mo old who has had 5 previous ear infections c. a 3 yr old whose sibling has had 4 ear infections d. a 7 yr old who has had 2 infections this year
a 2 mo old who has had 5 previous ear infections
the parents of a 6-yr-old who has a new diagnosis of asthma ask the nurse what to do to make their home a more allergy-free environment. what is the nurse's best response? a. use a humidifier in your child's room b. have your carpet cleaned chemically once a month c. wash household pets weekly d. avoid purchasing upholstered furniture
avoid purchasing upholstered furniture
where is the primary site of origin of the tumor in children who have neuroblastoma? a. bone b. kidney c. abdomen d. liver
c. abdomen
which intervention should be implemented after a bone marrow aspiration? a. ask the child to remain in a supine position b. place the child in an upright position for 4 hours c. keep the child NPO for 6h d. administer analgesics PRN for pain
d. administer analgesics PRN for pain
which is the nurse's best response to parents who ask what impact asthma will have on the child's future in sports? a. as long as your child takes prescribed asthma meds, the child will be fine. b. the earlier a child is diagnosed with asthma, the more significant the symptoms c. the earlier a child is diagnosed with asthma, the better the chance the child has of growing out of the disease d. your child should avoid playing contact sports and sports that require a lot of running
the earlier a child is diagnosed with asthma, the more significant the symptoms
What stage of Hodgkin's is a patient in when the disease is found in lymph node regions on both sides of the diaphragm? a. Stage 1 b. Stage 2 c. Stage 3 d. Stage 4
Stage 3
What are the diagnostic tests you would expect to do for Crohn's disease? select all that apply a) CBC b) upper GI series with a small bowel follow through c) CT scan d) CRP/ESR e) chest x-ray
a) CBC b) upper GI series with a small bowel follow through c) CT scan d) CRP/ESR
What are the clinical manifestations of Hirschsprung's Disease in a 5 year old child? (Select all that apply) a) Constipation b) Ribbon like, foul-smelling stool c) Hematemesis d) Anemia e) Jaundice
a) Constipation b) Ribbon like, foul-smelling stool d) Anemia
Where does distention occur for Hirschsprung's Disease? a) Proximal to the paralytic site b) Distal to the paralytic site c) At the paralytic site d) All of the above
a) Proximal to the paralytic site
Mom is trying to make sure her kid is eating extra healthy. How do you know if teaching is successful? a) baked potato with broiled chicken b) a triple big mac c) artichoke dip with pork sausage d) a leafy green kale salad with side of popcorn
a) baked potato with broiled chicken
What is the most common site of neuroblastoma? a. Adrenal gland b. Chest c. Neck d. Orbital bones
a. Adrenal gland
Which management of RSV would you question? a. Albuterol b. Antipyretic medications c. Encouraging fluids d. Taking the child (all bundled up) out into the cool winter air
a. Albuterol
A 5 y/o child with cleft palate comes in to the office with right ear pain, after diagnosing the patient with acute otitis media what is the best management option for this patient? a. Amoxicillin PO b. Tell parent to return in 2-3 days c. Instruct parent to preform warm soaks only d. Provide patient with Tylenol
a. Amoxicillin PO
What are the signs and symptoms of dehydration? (select all that apply) a. Changing level of consciousness b. Response to stimuli c. Increased heart rate d. Decreased heart rate e. Decreased urine output
a. Changing level of consciousness b. Response to stimuli c. Increased heart rate e. Decreased urine output
What are some reasons that infants lose more fluids than adults? (select all that apply) a. Greater amount of body surface area b. increased respiratory rate c. Increased metabolic rate d. they need less sleep than adults e. decreased metabolic rate
a. Greater amount of body surface area c. Increased metabolic rate
Which immunoglobulin would be elevated in asthma? a. IgE b. IgA c. IgD d. IgG
a. IgE
Which type of cancer is unresponsive to radiation? a. Osteogenic sarcoma b. Leukemia c. Neuroblastoma d. Hodgkins
a. Osteogenic sarcoma
which of the following confirms a diagnosis of Hodgkin disease in a 15 y/o? a. Reed-sternberg cells in the lymph nodes b. blast cells in the blood c. lymphocytes in the bone marrow d. VMA in the urine
a. Reed-sternberg cells in the lymph nodes
4. In leukemia, cells infiltrate which extramedullary sites? Select all that apply. a. Spleen b. Liver c. Lungs d. Kidneys
a. Spleen b. Liver
Which of the following is a characteristic of croup? (Select all that apply) a. Varying degrees of inspiratory stridor b. Barking cough c. Rhonchi d. Expiratory wheezes e. Hoarseness
a. Varying degrees of inspiratory stridor b. Barking cough e. Hoarseness
leukemia is characterized by: a. a high leukocyte count b. destruction of normal cells by abnormal cells c. low numbers of blast cells d. overproduction of blast cells
a. a high leukocyte count
a complete remission of leukemia is determined by: a. absence of clinical s/sx b. presence of more than 9% blast cells in bone marrow c. WBC of 10-12 d. presence of less than 5% blast cells in the bone marrow
a. absence of clinical s/sx d. presence of less than 5% blast cells in the bone marrow
the nurse is administering a dose of IV vincristine when the child suddenly starts complaining of difficulty breathing and is markedly flushed. the nurse's highest priority is to: a. administer oral antihistamine b. stop the infusion immediately c. slow down the infusion rate d. call the practitioner
a. administer oral antihistamine
what's the most appropriate management for rehydration of an 8 mo. old who has acute diarrhea and mild dehydration? a. beginning with oral rehydration therapy of 40-50 ml/kg within 4 hrs b. restarting lactose-free formula c. encouraging oral intake of clear fluids, such as fruit juices and gelatin d. feeding the BRAT diet
a. beginning with oral rehydration therapy of 40-50 ml/kg within 4 hrs
children with nasopharyngitis may be treated with: a. decongestants b. antihistamines c. expectorants d. cough suppressants
a. decongestants
neuroblastoma is often classified as a silent tumor because a. diagnosis is not usually made until after metastasis b. the primary site in intracranial c. the primary site is bone marrow d. dx is mad based on location of the primary site
a. diagnosis is not usually made until after metastasis
which of the following lab values, often found in acute diarrhea with dehydration, will return to normal after hydration of the patient? a. elevated Hb, Hct, BUN, creatinine b. decreased Hb, Hct, BUN, creatinine c. RBC in stool d. decreased WBC, Hb, Hct, BUN, creatinine
a. elevated Hb, Hct, BUN, creatinine
water intoxication can occur in children from, select all that apply: a. excessive intake of electrolyte-free formula b. administration of inappropriate hypotonic solutions c. dilution of formula with water d. isotonic dehydration e. vigorous hydration with water following a febrile illness f. fluid shifts from ICF to ECF
a. excessive intake of electrolyte-free formula b. administration of inappropriate hypotonic solutions c. dilution of formula with water e. vigorous hydration with water following a febrile illness
3 y/o admitted for fluid and electrolyte disturbances. the nurse's assessment should include (select all that apply): a. general appearance observation b. vital signs c. intake and output measurements d. daily weights e. review of lab results
a. general appearance observation b. vital signs c. intake and output measurements d. daily weights e. review of lab results
a candidate for a bone marrow transplant is the child who a. is unlikely to be cured by other means b. has acute leukemia c. has chronic leukemia d. has a compatible donor in their family
a. is unlikely to be cured by other means
which one of the following carcinogenic agents has been implicated in the development of childhood cancer? a. low doses of radiation b. excessive sun exposure c. exposure to cigarette smoke d. vitamin k given at birth
a. low doses of radiation
the child who receives a bone marrow transplant will require a. meticulous personal hygiene b. multiple peripheral sites for IV therapy c. less chemo before the transplant d. a room with laminar air flow
a. meticulous personal hygiene
the nurse recognizes which of the following individuals as having the least water content in relation to weight? a. obese adolescent female b. thin adolescent female c. obese adolescent male d. obese adolescent female
a. obese adolescent female
in preschool children, GERD may manifest with a. sx of heartburn and reswallowing b. intermittent vomiting c. respiratory conditions such as bronchospasm and pnuemonia d. failure to thrive, bleeding, dysphagia
a. sx of heartburn and reswallowing
an assessment finding that is consistent with the presence of a brain tumor is increased: a. temporal headaches b. appetite c. pulse rate d. BP
a. temporal headaches
which of the following is most likely to develop acute diarrhea? a. the 2 m/o infant who attends daycare b. the 18 m/o who stays at home with mom c. the 6 y/o who goes to public school d. the 2 y/o with two older brothers
a. the 2 m/o infant who attends daycare
to obtain relevant info from the parents of a child with fluid and electrolyte disturbances, the nurse should question the parents about: a. the type and amount of the child's intake and output b. the child's general appearance c. the child's weight over the past month d. whether they have taken the child's temp within the past 24h
a. the type and amount of the child's intake and output
3. Which of the following are triggers for an asthmatic episode? (Select all that apply) a. Anxiety b. Cockroach droppings c. Cold temperature d. Exercise e. Aspirin
all
client presents with inflamed fatty deposits under the skin, mouth ulcers, and rectal bleeding. what is the possible cause? a) GERD b) Crohn's disease c) Ulcerative colitis d) Enterocolitis
b) Crohn's disease
A 2 year old presents with vomiting, regurgitation, weight loss and is diagnosed with Gastroesophageal Reflux, what medication would you administer? a) Bethanecol (Urecholine) b) Lansoprazole (Prevacid) c) Ranitidine (Zantac) d) Bismuth Subsalicylate
b) Lansoprazole (Prevacid)
You have a patient with Crohn's disease. What meds would you expect to see on their list? select all that apply. a) Ativan b) Prednisone c) Flagyl d) loperadamine (immodium) e) infliximab
b) Prednisone c) Flagyl e) infliximab
At what point are children with RSV most contagious? a. 1-3 weeks b. 2-4 days c. 7-10 days d. 4-6 days
b. 2-4 days
What is the most common brain tumor in children? a. Astrocytoma b. Medulloblastoma c. Ependymoma c. Oligodendroglioma
b. Medulloblastoma
You have a 10 year old patient who is a member of the local swim team, which type of central line would be the best option for his chemotherapy treatment? a. Broviac b. Portacath c. Tell the patient, sorry no more swimming d. PICC
b. Portacath
Most common site for brain tumors? a. Temporal lobe b. Posterior fossa c. Anterior fossa d. Cerebrum
b. Posterior fossa
An experienced nurse is precepting a new nurse in the ED. A 2 year old patient presents with an abrupt onset of severe sore throat, fever, pain with swallowing, drooling from the mouth, and is leaning forward with her mouth open. The preceptor should intervene in which of the following cases? a. The new nurse anticipates the need for intubation b. The new nurse is about to place a tongue depressor in the patient's mouth c. The new nurse auscultates the lungs and assesses respiratory rate and rhythm d. The new nurse notifies the healthcare provider
b. The new nurse is about to place a tongue depressor in the patient's mouth
What is the first symptom you will hear in an asthmatic patient? a. Rhonchi b. Wheezing on expiration c. Stridor d. Vesicular lung sounds
b. Wheezing on expiration
What is the most common cause of intractable diarrhea of infancy? a. formula intolerance b. acute infectious diarrhea that was not managed well c. Chron's disease d. neuroblastoma
b. acute infectious diarrhea that was not managed well
edema formation can be caused by which of the following? a. decreased venous pressure b. alternation in capillary permeability c. increased plasma proteins d. increased tissue tension
b. alternation in capillary permeability
Chronic diarrhea: a. can be caused by viral, bacterial and parasitic pathogens b. is an increase in stool frequency and increased water content with a duration of more than 14 days c. is a leading cause of illness in children younger than 5 d. is often associated with URI or UTIs
b. is an increase in stool frequency and increased water content with a duration of more than 14 days
10% weight loss is considered ________ dehydration? a. mild b. moderate c. severe
b. moderate
2 y/o dx with uncomplicated diarrhea with no signs of dehydration. diagnostic eval should include which of the following? a. cultures of the stool b. presence of associated symptoms c. CBC d. urine specific gravity
b. presence of associated symptoms
children who receive reinduction therapy for a relapse of their acute lymphocytic leukemia are likely to: a. recover rapidly b. receive vincristine and prednisone c. receive a bone marrow transplant d. relapse 5 years after a complete remission
b. receive vincristine and prednisone
the nurse instructs the parents of a 4 mo. old with GERD to include which of the following in the infants care? a. stop breastfeeding, since breast milk is too thin and easily leads to reflux b. rescheduling of the family's routine to accommodate frequent feeding times c. increase infants intake of fruit and citrus juices d. try to increase feeding volume right before bedtime because this is the time when the stomach is more able to retain food
b. rescheduling of the family's routine to accommodate frequent feeding times
4 wk old brought to clinic by mom who is adding twice the required amount of dry formula powder to water in chloe's bottles to help her gain weight. what does the nurse recognize as true about this practice? a. the infant's kidneys are functionally mature at birth and able to handle this concentration of formula b. the infant's kidneys are functionally immature at birth and this concentration of formula can cause her to be dehydrated c. the infant's kidneys are functionally mature at birth and this concentration of formula will cause her to become overhydrated d. the infant's kidneys are functionally mature at birth but because of her greater BSA and longer GI tract, she needs to formula diluted
b. the infant's kidneys are functionally immature at birth and this concentration of formula can cause her to be dehydrated
which of the following info given to the parents about administration of a PPI for the tx of GERD is correct? a. the med is administered on a full stomach b. the med is administered 30 min before breakfast c. the med will be immediately effective to suppressing acid formation d. side effects of the drug include increased fatigue, dry mouth and bloating
b. the med is administered 30 min before breakfast
a 9 y/o with leukemia presents with a fever for 2 days and ANC of 190. nursing care should include a. placing child in isolation to prevent contamination of other patients b. wearing a face mask and practicing meticulous hand washing c. avoiding needlesticks and skin punctures such as IM injections d. immediately placing child on 100% O2
b. wearing a face mask and practicing meticulous hand washing
What is a long term complication of Crohn's disease that you should screen for earlier than recommended guidelines in someone who has Crohn's disease? a) irritable bowel syndrome b) anal fissures c) colon cancer d) GERD
c) colon cancer
Which of the following patients has the best prognosis based on favorable prognostic factors? a. 15 y/o female with a leukocyte count of 75,000 b. 3 y/o male with a leukocyte count of 50,000 c. 5 y/o female with a leukocyte count of 25,000 d. 20 y/o male with a Philadelphia chromosome abnormality
c. 5 y/o female with a leukocyte count of 25,000
what is the chief solute in ECF and the primary determinant of ECF? a. K b. Ca c. Na d. H2O
c. Na
Which of the following would NOT be the management of a brain tumor in a child <3 years? a. Chemotherapy b. Surgery c. Radiation
c. Radiation
Common viral organism indicated in pediatric diarrhea a. Cytomegalovirus b. Rhinovirus c. Rotavirus d. Parvovirus B19
c. Rotavirus
Which type of chemotherapy can cause foot drop? a. Methotrexate b. Adriamycin c. Viscristine d. Prednisone
c. Viscristine
which of the following diagnostic adjuncts is often used to diagnose acute epiglottitis? a. a 2-view chest radiograph (anterior and lateral views) b. throat inspection with tongue blade c. a lateral neck soft tissue radiograph d. laryngoscopy with mild sedation
c. a lateral neck soft tissue radiograph
an 8 y/o is to receive chemo. mom comments he isn't eating well because of nausea. one way to minimize the effects is to: a. administer antiemetic when complaining of nausea b. avoid foods in the room that make him nauseous c. administer antiemetic 30 min-1hr before chemo administration d. omit the chemo drug from his regimen
c. administer antiemetic 30 min-1hr before chemo administration
Acute diarrhea a. can be caused by celiacs b. can be related to hyperthyroidism c. can be caused by viral, bacterial and parasitic pathogens d. is an increase in stool frequency and increased water content with a duration of more than 14 days
c. can be caused by viral, bacterial and parasitic pathogens
of the following assessment findings in the post-op care of a child who had surgery to remove a brain tumor, the one with most serious implications is: a. a comatose child b. a serosanguineous drainage on the dressing c. colorless drainage on the dressing d. decreased muscle strength
c. colorless drainage on the dressing
which of the following dietary instructions given by the nurse to the parents of a kid with acute diarrhea without dehydration is correct? a. follow the BRAT diet for the first 24 h b. give clear fluid diet for first 24 h c. give fluids and normal diet during diarrhea illness d. keep pt NPO until stool output slows
c. give fluids and normal diet during diarrhea illness
rapid fluid replacement is contraindicated in which of the following types of dehydration? a. isotonic b. hypotonic c. hypertonic
c. hypertonic
in an attempt to prevent CNS invasion of malignant cells, children with leukemia usually receive prophylactic: a. cranial-spinal irradiation b. IV steroids c. intrathecal chemo d. IV methotrexate and cytarabine
c. intrathecal chemo
the cancer that occurs with the most frequency in children is a. lymphoma b. neuroblastoma c. leukemia d. melanoma
c. leukemia
which of the following is most likely to cause acute diarrhea? a. food allergy b. malabsorption syndromes c. parasitic infections d. immunodeficiency
c. parasitic infections
to confirm the dx of Hirschsprung dx, the nurse prepares the child for which one of the following tests? a. barium enema b. upper GI series c. rectal biopsy d. esophagoscopy
c. rectal biopsy
which nursing intervention is inappropriate for 6 mo. old with acute diarrhea and vomiting? a. ongoing assessment of I's and O's and physical appearance b. education of parents about necessity of oral rehydration solution c. rectal temps q4h to monitor fever elevations d. gentle cleansing of perianal areas and application of protective ointments
c. rectal temps q4h to monitor fever elevations
an infant with moderate dehydration has what clinical signs? a. mottled skin color, decreased pulse and respirations b. decreased urinary output, tachycardia, fever c. tachycardia, oliguria, cap refill within 2-4 sec d. tachycardia, bulging fontanelle, decreased BP
c. tachycardia, oliguria, cap refill within 2-4 sec
the severe cellular damage that is caused by chemo drugs infiltrating into surrounding tissue occurs when the chemotherapeutic agent is a(n): a. hormone b. steroid c. vesiccant d. antimetabolite
c. vesiccant
the nurse counsels the family of a 4 y/o that in the period immediately following remission, he must: a. consume a large amount of food items with K+ b. consume foods high in iron c. wear a surgical mask and practice meticulous hand washing when going out of his house d. all of above are important
c. wear a surgical mask and practice meticulous hand washing when going out of his house
13 m/o admitted for parenteral fluid therapy because of excessive vomiting. the nurse would recognize the most important aspect of care as: a. give oral fluids until parenteral fluid can be established b. question the HCP orders for fluid therapy of 0.9% sodium chloride c. withhold the ordered potassium additive until renal function is verified d. replace half of estimated fluid deficit over first 24 hours of parenteral fluid therapy
c. withhold the ordered potassium additive until renal function is verified
the most common bone cancer is most likely to occur in a child age: a. birth-4 b. 4-8 c. 8-10 d. 11+
d. 11+
hodgkin disease increases in incidence in children between the ages of: a. 1-5 b. 5-10 c. 11-14 d. 15-19
d. 15-19
What are symptoms of an osteosarcoma that do not occur with osteomyelitis? a. The region in which it occurs is the metaphyseal region of long bones (wide region) b. Flexion or change in position can alleviate the pain c. Pathological changes in bone matrix weaken the bone (weight bearing exercises can cause a bone break as well with osteomyelitis) d. Both B & C are correct
d. Both B & C are correct
Which precautionary isolation sign would you see posted on the door of a patient diagnosed with RSV? a. Special + b. Contact c. Airborne d. Contact + droplet
d. Contact + droplet
a transfer of gastric contents into the esophagus is termed a. esophageal atresia b. meckel diverticulum c. gastritis d. GERD
d. GERD
prevention measures for diarrhea in children include the following except: a. wash hands, utensils and work areas with hot soapy water after contact with raw meat b. proper disposal of soiled diapers c. during travel to areas where water may be contaminated, allow child to drink only bottled water from the container through a straw from home d. administer vaccines and meds to prevent travelers diarrhea before travel
d. administer vaccines and meds to prevent travelers diarrhea before travel
important prognostic factors in determining long-term survival for children with acute lymphoblastic leukemia include a. leukocyte count and leukemia cell burden b. age and gender c. immunologic subtype, FAB morphology, cytogenetics d. all of the above
d. all of the above
after bone marrow aspiration is performed on a child, the nurse should: a. apply an adhesive bandage b. place the child in trendelenburg c. ask the child to remain supine d. apply a pressure bandage
d. apply a pressure bandage
which of the following is not a serious and immediate physiologic disturbance associated with severe diarrheal disease? a. dehydration b. acid-base imbalance c. circulatory status impairment d. decreased growth rate
d. decreased growth rate
which of the following is a congenital anomaly that results in mechanical obstruction from inadequate motility of part of the intestine? a. intussusception b. short bowel syndrome c. crohn's d. hirschsprung disease
d. hirschsprung disease
the nurse would expect to see what clinical manifestations in the child diagnosed with Hirschsprung disease? a. history of bloody diarrhea, fever, vomiting b. irritability, severe abdominal cramps, fecal soiling c. decreased Hg, increased serum lipids, positive stool for O&P d. hx of constipation; abdominal distention; passage of ribbonlike foul-smelling stools
d. hx of constipation; abdominal distention; passage of ribbonlike foul-smelling stools
infants and young children are at high risk for fluid and electrolyte imbalances. which one of the following factors contributes to this vulnerability? a. decreased body surface area b. lower metabolic rate c. mature kidney function d. increased ECF volume
d. increased ECF volume
the major emphasis of nursing care for the vomiting infant or child is a. determining prior treatments used for the vomiting b. preventing the spread of infection c. managing the fever associated with the vomiting d. observing and reporting vomiting behavior and associated symptoms
d. observing and reporting vomiting behavior and associated symptoms
the early signs and symptoms of brain tumor in the infant a. are similar to those of a young child b. may be undectectable while the sutures are open c. will be demonstrated as vomiting after feedings d. will be demonstrated as headache and vomiting
d. will be demonstrated as headache and vomiting
What is the hallmark symptom of a brain tumor? a. Ataxia b. Visual disturbances c. Fatigue d. Loss of milestones e. Poor school performance f. Vomiting when child rises in morning
f. Vomiting when child rises in morning
the nurse is caring for an infant diagnosed with Hirschsprung disease. the mother states she is pregnant with a boy and wants to know if her new baby will likely have the disorder. select the best response a. genetics play a small role in Hirschsprung disease, so there is a chance the baby will develop it as well b. there is no evidence to support a genetic link, so it is very unlikely the baby will have it c. it is rarely seen in boys, so it is not likely your new baby will have Hirschsprung disease d. Hirschsprung disease is seen only in girls, so your new baby will not be at risk
genetics play a small role in Hirschsprung disease, so there is a chance the baby will develop it as well
what type of dehydration results from water loss in excess of electrolyte loss?
hypertonic
what type of dehydration occurs when the electrolyte deficit exceeds the water deficit? there is a greater proportional loss of ECF and plasma sodium concentration is usually <130 mEq/L
hypotonic
the nurse is caring for a 3-month old being evaluated for possible Hirshsprung disease. his parents call the nurse and show her his diaper containing large amount of mucous and bloody diarrhea. the nurse notes that the infant is irritable and his abdomen appears very distended. which should be the nurse's next action? a. reassure the parents that this is an expected finding and not uncommon b. call a code for a potential cardiac arrest, and stay with the infant c. immediately obtain all vital signs with a quick head-to-toe assessment d. obtain a stool sample for occult blood
immediately obtain all vital signs with a quick head-to-toe assessment
what type of diarrhea occurs in the first few months of life, persists for longer than 2 weeks with no recognized pathogens and is refractory to treatment?
incontractable diarrhea of infancy
what type of dehydration occurs when electrolyte and water deficits are present in balanced proportion?
isotonic
the limb salvage procedure is the treatment of choice for which bone cancer?
osteosarcoma
the most common bone cancer in children is?
osteosarcoma
the parent of a 5yr old states that the child has been having diarrhea for 24 hrs, vomited twice 2 hours ago, and now claims to be thirsty. the parent asks what to offer the child because the child is refusing Pedialyte. select the nurse's most appropriate response, a. you can offer clear diet soda b. Pedialyte is really the best thing for your child, who, if thirsty enough, will eventually think it c. pedialyte is really the best thing for you child. allow your child some choices in the way to take it by offering small amounts in a spoon, medicine cup or syringe d. it really does not matter what your child drinks as long as it is kept down. try offering small amounts of fluid in medicine cups
pedialyte is really the best thing for you child. allow your child some choices in the way to take it by offering small amounts in a spoon, medicine cup or syringe
which child is in the greatest need of emergency medical treatment? a. a 3 yr old who has a barky cough, afebrile, mild intercostal retractions b. 6 yr old with high fever, no spontaneous cough, frog-like croaking c. a 7yr old who has abrupt onset of moderate respiratory distress, a mild fever, and a barky cough d. 13-yr-old who has a high fever, stridor, purulent secretions
6 yr old with high fever, no spontaneous cough, frog-like croaking
What are clinical manifestations of brain tumors? a. Ataxia b. Visual disturbances c. Fatigue d. Loss of milestones e. Poor school performance f. Vomiting when child rises in morning g. All of the above
All of the above
If you are infected with RSV once, you are immune from getting it again - true or false?
False
Which of the following are NOT symptoms of Hodgkin's disease? Select all that apply. a. Enlarged non-painful lymph nodes b. Persistent, non-productive cough c. Abdominal pain d. Low grade intermittent fever e. Weight loss f. Night sweats g. Nausea h. Pruritus i. None of the above, all are symptoms
None of the above, all are symptoms
which of the following instructions for treating the child for mild dehydration is not correct? a. administer 2-5 ml of ORT q 2-3m until they can tolerate more b. give zofran to the child with acute gastroenteritis and vomiting may prevent the need for IV therapy c. ORT consists of replacement of fluid loss over 4-6 h d. ORT shouldn't be started until after all vomiting has stopped
ORT shouldn't be started until after all vomiting has stopped
the nurse receives a call from the mother of a 6 mo old who describes her child as alternatively sleepy and fussy. she states that her infant vomited once this morning and had 2 episodes of diarrhea. the last episode contained mucous and a small amount of blood. she asks the nurse what she should do. select the nurse's best response a. your infant will need to have some tests in the emergency room to determine if anything serious is going on b. try feeding your infant in 30 min; in the event of repeat vomiting, bring the infant to the ER for some tests and IV rehydration c. many infants display these symptoms when they develop an allergy to the formula they are receiving; try switching to a soy-based formula d. do not worry about the blood and mucous in the stool; it is not unusual for infants to have blood in their stools because their intestines are more sensitive
your infant will need to have some tests in the emergency room to determine if anything serious is going on
Which child can be discharged without further evaluation? 1. A 2-year-old who has had 24 hours of watery diarrhea that has changed to bloody diarrhea in the past 12 hours. 2. A 2-year-old who had a relapse of one diarrhea episode after restarting a normal diet. 3. A 6-year-old who has been having vomiting and diarrhea for 2 days and has decreased urine output. 4. A 10-year-old who has just returned from a Scout camping trip and has had several episodes of diarrhea.
A 2-year-old who had a relapse of one diarrhea episode after restarting a normal diet.
the nurse is caring for a child being treated for ALL. lab results indicate the child has a WBC count of 5000 with 5% polys and 3% bands. which of the following is most appropriate? a. ANC is 400. child is neutropenic b. ANC is 800. child is neutropenic c. ANC is 4000. child is not neutropenic d. ANC is 5800. child is not neutropenic
a. ANC is 400. child is neutropenic
which of the following is correct re: all prognostic factors for determining survival for a child newly diagnosed with ALL? a. the initial WBC count on dx b. the race of the child c. the amount of time needed to initiate tx d. the allergy hx of the child
a. the initial WBC count on dx
a 4-mo old is brought the ER with severe dehydration. the HR is 198, BP 63/38. the infant's anterior fontanelle is sunken. the nurse notes the infant doesn't cry when the IV line is inserted. the child's parents state that she has not "held anything down" in 18 hrs. the nurse obtains a finger-stick blood sugar of 94. which would the nurse expect to do immediately? a. administer a bolus of NS b. administer a bolus of D10W c. administer a bolus of NS with 5% dextrose added to the solution d. offer the child an oral rehydrating solution such as pedialyte
administer a bolus of NS with 5% dextrose added to the solution
the nurse is caring for a 2 yr old child who was admitted to the pediatric unit for moderate dehydration due to vomiting and diarrhea. the child is restless, with periods of irritability. the child is afebrile with a HR of 148 and BP of 90/42. baseline labs reveal Na 152, Cl 119, glucose 115. the parents state that the child has not urinated in 12 hrs. after establishing a saline lock, the nurse reviews the physician's orders. which order should the nurse question? a. administer a saline bolus of 10 ml/kg, which may be repeated if the child doesn't urinate b. recheck serum electrolytes in 12 hrs c. after the saline bolus, begin maintenance fluids of D5 1/2 NS with 10 mEq KCl/L d. give clear liquid diet as tolerated
after the saline bolus, begin maintenance fluids of D5 1/2 NS with 10 mEq KCl/L
since the advent of immunization for H. influenza type B, there has been a decrease in the incidence of: a. laryngotracheobronchitis b. acute epiglottitis c. bacterial tracheitis d. bronchiolitis
b. acute epiglottitis
of the following antibiotics, the one that would be most likely to be prescribed for uncomplicated otitis media would be: a. tetracylcine b. amoxicillin c. gentamicin d. methicillin
b. amoxicillin
which of the following is a (are) reason(s) to do a lumbar puncture on a child with a diagnosis of leukemia. select all that apply: a. rule out meningitis b. assess the CNS for infiltration c. give intrathecal chemotherapy d. determine increased ICP e. stage the leukemia
b. assess the CNS for infiltration c. give intrathecal chemotherapy
what are the clinical manifestations of non-Hodgkin lymphoma? a. basically the same as those in Hodgkin dx b. depends on the anatomical site and extent of involvement c. those that affect the abdomen, as non-Hodgkin lymphoma is a fast-growing cancer in very young children d. changes that occur in the lower extremities
b. depends on the anatomical site and extent of involvement
the nurse is caring for a 10 y/o with leukemia who is receiving chemo. the child is on neutropenic precautions. friends of the child come to the desk and ask for a vase for flowers. whats the best response? a. i'll get you a vase b. the flowers are beautiful but shouldn't be put in the room at this time c. as soon as I can wash the vase I'll bring it to your room d. get rid of the flowers
b. the flowers are beautiful but shouldn't be put in the room at this time
a school-age child has been diagnosed with nasopharyngitis. the parent is concerned because the child has had little or no appetite for the last 24 hours. which is the nurse's best response? a. do not be concerned; is it common for children to have a decreased appetite during a respiratory illness. b. be sure your child is taking an adequate amount of fluids. the appetite should return soon c. try offering the child some favorite food. maybe that will improve the appetite d. you need to force your child to eat whatever you can; adequate nutrition is essential
be sure your child is taking an adequate amount of fluids. the appetite should return soon
the nurse should suspect epiglottitis if the child has: a. cough, sore throat, agitation b. cough, drooling, retractions c. drooling, agitation, absence of cough d. hoarseness, retractions, absence of cough
c. drooling, agitation, absence of cough
a teen is seen in clinic for a possible diagnosis of Hodgkin disease. the nurse is aware that which of the following symptoms should make the physician suspect Hodgkin disease? a. fever, fatigue, pain in joints b. anorexia with weight loss c. enlarged, painless, movable lymph nodes in cervical area d. enlarged liver with jaundice
c. enlarged, painless, movable lymph nodes in cervical area
which of the following should be done to protect the CNS from the invasion of malignant cells in a child newly diagnosed with leukemia? a. cranial and spinal radiation b. IV steroid therapy c. intrathecal chemo d. high-dose IV chemo
c. intrathecal chemo
the most likely reason that the respiratory tract infection rate increases drastically in the age range from 3-6 mo. is that the: a. infant exposure to pathogens is greatly increased during this time b. viral agents that are mild in older children are more severe in infants c. maternal antibodies have disappeared and children's own antibody production is immature d. diameter of the airways is smaller in the infant than older child
c. maternal antibodies have disappeared and children's own antibody production is immature
the nurse is caring for a child with a dx of ALL, who is receiving chemo. the nurse notes that the child's platelet count is 20,000 mm3. based on this lab finding what info should the nurse provide to the child and parents? a. a soft toothbrush should be used for mouth care b. isolation precautions should be started immediately c. the child's vital signs, including BP should be monitored Q4H d. all visitors should be discouraged from coming to see the family
c. the child's vital signs, including BP should be monitored Q4H
the nurse receives a call from a parent of a child with leukemia in remission. the parent says the child has been exposed to chicken pox. the hcild has never had chicken pox. which of the following responses is most appropriate for the nurse? a. you need to monitor temp frequently and call back if greater than 101 b. no need to be concerned c. you need to bring the child to the clinic for a chicken pox immunoglobulin vaccine d. your child will need to be isolated for the next two weeks
c. you need to bring the child to the clinic for a chicken pox immunoglobulin vaccine
the parent of a child with croup tells the nurse that her other child just had croup and it cleared in a couple days without intervention. she asks the nurse why this child is exhibiting worse symptoms and needs to be hospitalized. whats the best response? a. some children just react differently to viruses, it is best to treat each child as an individual b. younger children have wider airways that make it easier for bacteria to enter and colonize c. younger children have short and wide eustachian tubes making them more susceptible to respiratory infections d. children younger than 3 years usually exhibit worse symptoms because their immune systems are not as developed
children younger than 3 years usually exhibit worse symptoms because their immune systems are not as developed
which is the nurse's best response to the parent with a child diagnosed with epiglottitis who asks what the tx will be? a. complete a course of IV antibiotics b. surgery to remove tonsils c. 10 days of aerosolized ribavirin d. no intervention
complete a course of IV antibiotics
the nurse is caring for a 9 mo old with diarrhea secondary to rotavirus. the child has not vomited and is mildly dehydrated. which likely to be included in the discharge teaching? a. administer Imodium as needed b. administer Kaopectate as needed c. continue breastfeeding per routine d. the infant may return to day care 24 hours after antibiotics have been started
continue breastfeeding per routine
which age group has the highest asthma mortality risk? a. infants and toddlers b. preschoolers c. school age d. adolescents
d. adolescents
prednisone is given to children who are being treated for leukemia. why is this med given as part of the treatment plan? a. enhances protein metabolism b. enhances sodium excretion c. increases absorption of chemotherapy d. destroys abnormal lymphocytes
d. destroys abnormal lymphocytes
the nurse is discharging a child who has just received chemo for neuroblastoma. which of the following statements made by the child's parents indicate a need for additional teaching? a. I'll inspect the skin often for lesions b. i'll do mouth care daily and look for sores c. i'll wash my hands before caring for my child d. i'll take a rectal temp daily and report temps greater than 101 immediately to the HCP
d. i'll take a rectal temp daily and report temps greater than 101 immediately to the HCP
a child with leukemia is receiving chemo and is complaining of nausea. the nurse has been giving the scheduled antiemetic. which of the following should the nurse do when the child is nauseated? a. encourage low-protein foods b. encourage low cal foods c. offer favorite foods d. offer cool, clear liquids
d. offer cool, clear liquids
offensive mouth odor, persistent dry cough, voice with muffled quality are commonly the result of: a. pneumonia b. otitis externa c. tonsilitis d. otitis media
d. otitis media
the nurse would expect which of the following conditions to produce an increased fluid requirement? a. heart failure b. high ICP c. mechanical ventilation d. tachypnea
d. tachypnea
recurrent otitis media with effusion after a total of 4-6 mo. of bilateral effusion with bilateral hearing deficit would most likely be managed therapeutically by: a. tonsillectomy b. steroids c. polyvalent pneumococcal polysaccharide vaccine d. tympanostomy tubes
d. tympanostomy tubes
which should the nurse include in the plan of care to decrease symptoms of gastroesophageal reflux (GER) in a 2-mo old. select all that apply a. place the infant in an infant seat immediately after feedings. b. place the infant in the prone position immediately after feeding to decrease the risk of aspiration c. encourage the parents not to worry because most infants outgrow GER within the first year of life d. encourage the parents to hold the infant in an upright position for 30 min following a feeding e. suggest that the parents burp the infant after every 1-2 oz consumed
encourage the parents to hold the infant in an upright position for 30 min following a feeding and suggest that the parents burp the infant after every 1-2 oz consumed
a mother is crying and tells the nurse that she should have brought her son in yesterday when he said his throat was sore. which is the nurses best response to the parent who's child is diagnosed with epiglottitis, who is in severe distress and is in need intubation? a. children this age rarely get epiglottitis, you shouldn't blame yourself b. it's always better to have your child evaluated at first sign of illness instead of wait until symptoms worsen c. epiglottitis is slowly progressive, so early intervention may have decreased the extent of your sons symptoms d. epiglottitis is rapidly progressive, you couldn't have predicted his symptoms would've worsened so quickly
epiglottitis is rapidly progressive, you couldn't have predicted his symptoms would've worsened so quickly
the nurse receives a call from the parent of a 10 mo old who has vomited three times in the past 8 hours. the parent describes the baby as playful and wanting to drink. the parent asks the nurse what to give the child. select the nurse's best response a. replace the next feeding with regular water, and see if that is better tolerated b. do not allow your baby to eat any solids; give half the normal formula feeding, and see if that is better tolerated c. do not let your baby eat or drink anything for 24 hrs to give the stomach a chance to rest d. give your child 1/2 oz of pedialyte every 10 min. if vomiting continues, wait an hour, and then what your previously gave.
give your child 1/2 oz of pedialyte every 10 min. if vomiting continues, wait an hour, and then what your previously gave.
which physical findings would be of most concern in an infant with respiratory distress? a. tachypnea b. mild retractions c. wheezing d. grunting
grunting
which statement by the parents of a toddler with repeated otitis media indicates they need additional teaching? a. if I quit smoking, my child may have a decreased chance of getting an ear infection b. as my child gets older, he should have fewer ear infections, because his immune system will be more developed c. my child will have fewer ear infections if he has his tonsils removed d. my child may need a speech evaluation
if I quit smoking, my child may have a decreased chance of getting an ear infection
a 7 mo. old has a low-grade fever, nasal congestion and a mild cough. what should the nursing care management of this child include? a. maintaining strict bedrest b. avoiding contact with family members c. instilling saline nose drops and bulb suctioning d. keeping the head of the bed flat
instilling saline nose drops and bulb suctioning
what is the diagnostic for epiglottitis? a. blood test b. throat swab c. lateral neck x-ray of soft tissue d. s/sx
lateral neck x-ray of soft tissue
what should the nurse's first action with a child with a fever, dysphagia, drooling, tachycardia, tachypnea? a. immediate IV placement b. immediate respiratory tx c. thorough physical assessment d. lateral radiographs
lateral radiographs
how will a child with respiratory distress and stridor and who is diagnosed with RSV be treated? a. IV antibiotics b. IV steroids c. nebulized racemic epinephrine d. alternating doses of tylenol and motrin
nebulized racemic epinephrine
the nurse is administering Prilosec (omeprazole) to a 3-month old with GER. The child's parents ask the nurse how the med works. select the best response a. prilosec is a proton pump inhabitor that is commonly used for reflux in infants b. prilosec decreases stomach acid, so it will not be as irritating when your child spits up c. prilosec helps food move through the stomach quicker, so there will be less chance for reflux d. prilosec releases the pressure of the lower esophageal sphincter
prilosec decreases stomach acid, so it will not be as irritating when your child spits up
what would the nurse advise the parent of a child with a barky cough that gets worse at night? a. take the child outside into the more humid night air for 15 min b. take the child to the ER immediately c. give the child an OTC cough suppressant d. give the child warm liquids to soothe the throat
take the child outside into the more humid night air for 15 min
which is the nurses best response to the parent of an infant diagnosed with the first otitis media who wonders about long-term effects? a. the child could suffer hearing loss b. the child could suffer some speech delays c. the child could suffer recurrent ear infections d. the child could require ear tubes
the child could suffer recurrent ear infections
which assessment is of greatest concern in a 15-mo-old? a. the child is lying down, moderate retractions, low grade fever and nasal congestion b. the child is in the tripod position, diminished breath sounds, muffled cough c. the child is sitting up, coarse breath sounds, coughing, fussy d. the child is restless and crying, bilateral wheezes, feeding poorly
the child is in the tripod position, diminished breath sounds, muffled cough
the nurse knows that Nissen fundoplication involves which of the following? a. the fundus of the stomach is wrapped around the inferior stomach, mimicking a lower esophageal sphincter b. the fundus of the stomach is wrapped around the interior esophagus, mimicking a cardiac sphincter c. the fundus of the stomach is wrapped around the middle portion of the stomach, decreasing the capacity of the stomach d. the fundus of the stomach is dilated, decreasing the likelihood of reflux
the fundus of the stomach is wrapped around the interior esophagus, mimicking a cardiac sphincter
the nurse is caring for an infant newly diagnosed with Hirschsprung disease. what does the nurse understand about the patient's condition? a. there is a lack of peristalsis in the large intestine and an accumulation of bowel contents, leading to abdominal distention b. there is excessive peristalsis throughout the intestine, resulting in abdominal distention c. there is a small-bowel obstruction leading to ribbon-like stools d. there is inflammation throughout the large intestine, leading to an accumulation of intestinal contents and abdominal distention
there is a lack of peristalsis in the large intestine and an accumulation of bowel contents, leading to abdominal distention
which should the nurse instruct children to do to stop the spread of influenza in the classroom? a. stay home if they have a runny nose and cough b. wash their hands after using the restroom c. wash their hands after sneezing d. have a flu shot annually
wash their hands after sneezing
a parent asks the nurse how it will be determined if their child has respiratory syncytial virus (RSV). which is the nurse's best response? a. we will do a simple blood test to determine whether your child has RSV b. there is no specific test for RSV. the diagnosis is made based on the child's symptoms c. we will swab your child's nose and send the specimen for testing d. we will have to send a viral culture to an outside lab for testing
we will swab your child's nose and send the specimen for testing
the parent of a child with frequent ear infections asks the nurse if there is anything that can be done to help avoid future ear infections. which is the nurse's best response? a. your child should be put on daily dose of Singular (motelukast) b. your child should be kept away from tobacco smoke c. your child should be kept away from other children with otitis media d. your child should always wear a hat when outside
your child should be kept away from tobacco smoke
