Peds CMS test

Which interventions should the nurse include in the infant's plan of care with a 12 month old infant who is 6 hours postoperative following cleft repair. Select all that apply. Apply and release elbow restraints every hour Encourage the parents to rock the infant Place the infant upright in a seated position NO objects into mouth (pacifiers, straws, tongue depressors) Point bottle down & away from the cleft Slow feeding to 20 - 30 minutes and burp often

ALL OF THEM: *Apply and release elbow restraints every hour *Encourage the parents to rock the infant *Place the infant upright in a seated position *NO objects into mouth (pacifiers, straws, tongue depressors) *Point bottle down & away from the cleft *Slow feeding to 20 - 30 minutes and burp often

A nurse is assessing a school-aged child immediately following an appendix rupture repair. Which of the following findings should the nurse expect?

Absence of peristalsis

A nurse is caring for a preschooler who is scheduled for hydrotherapy treatment for wound debridement following a burn injury. Which of the following actions should the nurse take prior to the procedure?

Administer an analgesic to the child.

Tubes that are inserted through the tympanic membrane, commonly to treat chronic otitis media; also called tympanostomy tubes or ventilation tubes

Pressure-equalizing (PE) tubes

congenital cardiac condition characterized by a narrowing of the aorta usually neat the ductus arteriosus resulting in obstruction of blood flow from ventricle

coarctation of the aorta

While caring for an infant diagnosed with Down's syndrome,(RN) notes cyanosis that increases with crying, and recognizes that this clinical presentation is an indicator of what congenital heart defect?

atrioventricular canal defect

Infants' respirations are primarily ________

diaphragmatic

While caring for a 9-year-old with acute glomerulonephritis, the nurse knows which clinical assessment finding is priority to monitor?

Blood Pressure

What test can show severe neck stiffness causing a patient's hips and knees to flex when the neck is flexed.

Brudzinski sign (meningitis)

What deformity results from the cerebellum, the medulla oblongata, and the fourth ventricle displacing into the cervical canal, resulting in an obstruction of the CSF and causing hydrocephalus.

Chiari Malformation

A infant/child presenting with fever that is not reduced by antipyretics for at least 5 days as well as strawberry tongue is showing signs of what?

Kawasaki Disease

Treatment for Strabismus is _________

Patch over the stronger eye

Which type of hearing loss is characterized by interference with the loudness of sound

conductive

Early symptoms of Rey's Syndrome

diarrhea rapid breathing vomiting severe fatigue

The nurse is percussing the chest of a child with a suspected respiratory disorder. What sound might the nurse note that would indicate pneumonia?

dull sound

What is the the most common form of hearing loss, also called nerve deafness; caused by damage to the cochlea's receptor cells or to the auditory nerves

sensorineural hearing loss

Universal hypertension screening for children beginning at age ______ is recommended.

three

During the assessment of lab work obtained for a 5 year old male, the registered nurse (RN) is aware that which lab value supports the diagnosis of nephrotic syndrome? Select all that apply. urine protein is 2+ urine color: bloody serum albumin of 2.0 g/dL serum cholesterol of 375 mg/dL

urine protein is 2+ serum albumin of 2.0 g/dL serum cholesterol of 375 mg/dL

A nurse is preparing an adolescent for a lumbar puncture. Which of the following actions should the nurse take?

Apply topical analgesic cream to the site 1 hr prior to the procedure.

Nephroblastoma is the most common type of kidney cancer in children also called Wilms tumor. What are clinical manifestations of this?

Abdominal Bulge on one side (DO NOT PALPATE ABDOMEN)

When families become exhausted with home care of their child with special needs, _______ care resources may be able to provide relief.

Respite

A life-threatening condition that causes massive brain swelling, which leads to seizures & liver damage.

Reyes Syndrome

Spina bifida is one of the possible neural tube defects that can occur during early embryological development. Which of the following definitions most accurately describes meningocele

Sac formation containing meninges and spinal fluid.

A 6-year-old child is brought to the clinic by his parents. The parents state, "He had a sore throat for a couple of days and now his temperature is over 102°F (38.9°C). He has this rash on his face and chest that looks like sunburn but feels really rough." What would the nurse suspect?

Scarlet fever

__________ A disorder where the eyes appear crossed (crossed eyes) & don't look in the same direction at the same time.

Strabismus

What are biophysical interventions for pain management?

Sucking and sucrose (sugar water good for infants) Massage and Pressure Heat and cold applications

The nurse identifies which finding as an early warning sign of cerebral palsy (CP)?

The infant has poor head control

How should a nurse instruct a parent of a child who has bacterial conjunctivitis to instill eye drops?

Wipe from the inner canthus downward and outward away from the opposite eye

A nurse is providing teaching to the parent of an infant who has diaper dermatitis. The nurse should instruct the parent to apply which of the following to the affected area?

Zinc oxide

What is the most important assessment in the plan of care with a 3-month-old infant with meningitis?

fontanel assessment

A surgically placed feeding tube from the exterior of the body into the stomach is called _________

gastrostomy tube

Nasogastric or orogastric tube going from the nose to the stomach for infants is called __________

gavage feeding

What physiological symptoms can an infant present when in pain?

increase HR decrease vagal tone decrease oxygen sat palmar/plantar sweating *use CRIES scale

A nurse is planning care for a school-aged child who is in the oliguric phase of acute kidney injury and has a sodium level of 129 mEq/L. Which of the following interventions should the nurse include in the plan?

Initiate seizure precautions for the child.

A nurse is assessing a school-aged child who has meningitis. Which of the following findings is the priority of the nurse to report to the provider?

Petechiae on the lower extremities

What are the steps to relieving hypercyanotic spells?

*place child/infant in knee to chest position *provide oxygen *supply IV fluids *Administer propranolol (0.1mg/kg)

_______, A defect in brain development resulting in small or missing brain hemispheres, skull, and scalp

Anencephaly

An infant who is experiencing heart failure will have what sx? SATA *Nasal Flaring *Bradycardia *Cool Extremities *Peripheral Edema *Increase Urine output

*Nasal Flaring *Cool Extremities *Peripheral Edema

The vision impairment in which the child can see objects at close range but not at a distance is known as _______?

myopia

A nurse is caring for a school-aged child who is in Buck's traction following a leg fracture 24-hours ago. Which of the following actions should the nurse take?

Assess peripheral pulses once every 4 hr.

A nurse is caring for a child who has spastic cerebral palsy. Which of the following findings should the nurse expect? (Select all that apply) A. Negative Babinski reflex B. Ankle clonus C. Exaggerated stretch reflexes D. Uncontrollable movements of the face E. Contractures

B, C, E Rationale: The nurse should expect a child who has spastic cerebral palsy to exhibit ankle clonus, which is a rhythmic reflex tremor when the foot is dorsiflexed; The nurse should expect a child who has spastic cerebral palsy to exhibit spasticity or exaggerated stretch reflexes; he nurse should expect a child who has spastic cerebral palsy to exhibit contractures due to the tightening of the muscles.

A 5-year-old child is diagnosed with acute otitis media. Which nursing intervention would be priority?

Relieving the child's pain

The nurse is aware that which medication will help the most with the pediatric client's tight and spastic muscles with cerebral palsy?

baclofen

A nurse is reviewing the lumbar puncture results of a school-aged child who has suspected bacterial meningitis. Which of the following findings should the nurse identify as an indication of bacterial meningitis?

Increased protein concentration

When the health care provider looks in a child's mouth during a sick-visit examination, the parent exclaims: "The tongue is bright strawberry red! It was not like that yesterday." The health care provider would most likely prescribe which medication based on the probable diagnosis?

Penicillin to prevent acute glomerulonephritis

________ results from failure of the anterior portion of the neural tube to close deviations below the mean for the age of infant. Generally results in intellectual disability due to the lack of functioning brain tissue

Microcephaly

_______ ,A protrusion of the brain and meninges through a skull defect that results from failure of the anterior portion of the neural tube to close

Encephalocele

What education should be given to parents of a child with Kawasaki Disease

No live virus for 11 months

The infant with bacterial meningitis may rest in the ____________position.

opisthotonic

Which instructions should the nurse include with a child who has juvenile idiopathic arthritis (JIA).?

Administer prednisone on an alternate-day schedule

What is the numeric pain scale used for?

Ages 5 and up using the OPQRST to question patient Onset Provocation Quality Radiation Severity Time

___________ , A type of blindness or reduced visual acuity that can occur if strabismus is untreated by age 5 or 6.

Amblyopia

Which order should the nurse prioritize first with a 4-month-old infant with following a positive lumbar puncture indicating bacterial meningitis?

Give ciprofloxacin IV immediately

What test can be done to show severe stiffness of the hamstrings causing an inability to straighten the leg when the hip is flexed to 90 degrees.

Kernig sign (meningitis)

A nurse is assessing an infant who has a ventricular septal defect. Which of the following findings should the nurse expect?

Loud, harsh murmur

A nurse is caring for a 15-year-old client following a head injury. Which of the following finding should the nurse identify as an indication that the child is developing SIADH?

Mental confusion

The nurse must confirm that ______________ screening was performed after 48 hours of age and before discharge from the birthing unit

Metabolic